01.2019
AACS Continuing Education
Accreditation Team Member Voucher
Directions
Print legibly.
This form is required to verify participation as a member of an AACS (or AACS-affiliate) school accreditation team.
Team chair’s signature is required.
Retain this form. When you submit certification renewal application, include this form with your other renewal paperwork.
For certificate renewal, no more than 30 contact hours may be for serving on school accreditation teams.
Service on a team is valued at 10 contact hours.
Team Member Information
Name E-mail
Certification Area
Preschool
Kindergarten
Elementary
Secondary
All-Level (Music, Art, PE)
Special Education
Specialist (Bible, CIT, Counseling)
Administrator
Current Certificate Endorsement(s) (Elementary Ed, Music, Math, etc.)
Information for School Visited by Accreditation Team
Name of School Visited by the Accreditation Team ____________________________________________________________________
City and State of School __________________________________________________________________________________________
Dates of Accreditation Visit _______________________________________________________________________________________
Accrediting Agency (AACS or State Affiliate) _________________________________________________________________________
Team Chair Information
Name of Accreditation Team Chair (print) ___________________________________________________________________________
Accreditation Team Chair’s Signature* ____________________________________________________ Date ____________________
*Team Chair’s Signature verifies the accreditation team member’s participation.
For Office Use Only
Continuing education credit granted
Continuing education credit denied Explanation of denial:
Number of contact hours allowed for activity: _______
Conditions or limitations:
Signature of AACS official Date of Reply_____________________
