GREEN APPLE ACCREDITATION OF CHILDREN'S SERVICES (GAACS)

License Exempt Application

Please review the GAACS License Exempt Approval Step by Step Process carefully. It is important to note that each step in the process must be completed before exempt approval may be granted.

If you have any questions, please contact our offices at Phone: (904) 293-1357 or Email: info@gaacs.org. Keep a copy of the License Exempt Application for your records.

APPROVAL STEP BY STEP PROCESS

Step 1: Complete Membership Application (if not completed already).

Step 2: Complete License Exempt Application.

Step 3: Download the Health and Safety Standards. Must be completed, signed, and notarized.

Step 4: Obtain liability insurance showing Green Apple Accreditation of Children's Services as an additional insured.

Step 5: Submit Health and Safety Check Request (providers that do not participate in School Readiness)

If you are unable to adhere to the GAACS Approval Step by Step Process for any reason then do not proceed.

PROVIDER INFORMATION

Name of Organization *

Name of Child Care Program *

Your Name *

Physical Address *

City *

State *

Zip Code *

Country

Phone

Alternate Phone

Email Address

Website

Administrator *

Email Address

Administrator 2

Email Address

Are you a first-time applicant or renewing applicant? *

First Time Applicant

Renewing Applicant

Save & Return

Use an account to return to saved work.

Program Category

Please select the category that your program falls in. (Check all that apply)

An integral part of: *

Church - Early Education Center

Church - Enrichment Program

Parochial School

Age Groups Served: *

Birth to Five ONLY

Birth to Five AND School Age

School Age ONLY

Incorporated? *

Yes

Name of Church or Parochial School *

Number of Staff *

Number of Children Served *

Year Established *

CHECKLIST (THE SCHOOL HAS….)

Checklist *

	yes	no
Applied for Membership: Submitted an Application for Membership to GAACS.	yes	no
Downloaded the Health and Safety Standards, Manual	yes	no
Church or Parochial School Affiliation	yes	no
Received State and Local Background clearance for the Owner and Operator and will require all employees to present a valid State and Local background clearance PRIOR to working with children.	yes	no

License Exempt Application Fees

License Exempt Fees: *

Early Education Center Membership (if not already paid)

Enrichment (School Age) Program Membership (if not already paid)

License Exempt Application (all providers)

License Exempt Site Visit Request (some providers)

Should I Request a Health and Safety Check?

If the provider intends to or is currently participating in school readiness then it is NOT required to have a Health and Safety Check by Green Apple validators to receive license exempt approval. Instead the provider shall submit a copy of the most recent inspection/checklist from the department or local licensing agency within thirty days from the date of application. If the provider does not intend to or is not currently participating in school readiness then it shall submit a Request for Health and Safety Check by Green Apple validators prior to license exempt approval.

ALL FEES ARE NONREFUNDABLE AND NONTRANSFERABLE

ONCE THIS APPLICATION IS PROCESSED IT CANNOT BE CANCELLED.

Insurance & Health Information

VALID Certificate of Liabilty Insurance *

Transportation Affidavit *

Please upload the last page from the Health & Safety Manual filled out AND notarized. *

Health & Safety Manual *

Notarized letter to DCF about being an integral part of a church

Proof of School Readiness Participation

Additional Information

Resolution

THE FOLLOWING RESOLUTIONS IDENTIFY IMPORTANT ASPECTS OF MEMBERSHIP IN GAACS. CAREFULLY CONSIDER EACH ONE AND RESPOND BY CHECKING THE ANSWER WHICH BEST REPRESENTS THE FOUNDATIONAL BELIEFS AND POLICIES UPON WHICH YOUR ORGANIZATION OPERATES.

a. We declare our full agreement with the Green Apple Policies and Procedures Manual. *

Yes

b. We declare our full agreement with GAACS Mission Statement. *

Yes

c. We have the written policies regarding non-discrimination. *

Yes

d. We hold the necessary legal status to operate. *

Yes

e. We have a governing body, board, committee, or head of school. *

Yes

f. We are in compliance with all applicable federal, state, or provincial and local laws governing our organization. *

Yes

g. We declare that we have read the governing procedures outlined in the Policies and Procedures Manual. *

Yes

h. We grant GAACS permission list our organization in the member directory and all website publications. We understand that the membership directory is updated periodically. *

Yes

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.

Name *

Title *

Today's Date *

Signature *

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