Site Survey Inspection

Today's Date * +

Organization Name *

Name of Person Requesting Inspection *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Purpose of Inspection *

Behavioral Health Survey $1500

Early Education Center $600

Enrichment Program $600

K - 12 School $600

License Exempt Provider $150

Corporate Site Visits (Education) $8,000

Corporate Site Visits (Behavioral Health) $19,500

Current Total:

$0.00

Credit Memo

Block Out Dates (if applicable)

Calendar +

Any additional information for the Validators/Inspectors

Resolutions

Be it resolved that we, the governing body of this organization do hereby declare that we have answered the above statements honestly and in complete accordance with the basis, principles, and policies that govern this organization and that a motion to this effect is recorded in the official minutes of the organization. We indemnify and hold harmless Green Apple Accreditation of Children's Services (GAACS), its representatives, successors, and its members both now and forever. Furthermore, I certify that I have the authority to complete this application on behalf of the organization. I/We have read and agree to the REFUND POLICY, FEES, AND TERM LIMITS and understand that ALL FEES ARE NONREFUNDABLE and NONTRANSFERABLE. The transaction may not be canceled once it is processed. There are additional FEES for Site Visit (Survey) Inspections and Travel Expenses (may be assessed), which will be due in furtherance of this application for accreditation. I/We have also read and agree to the PRIVACY POLICY and POLICIES AND PROCEDURES MANUAL.

Print Your Name *

Signature of requesting person *

clear