Staff Required Documents

STAFF REQUIRED DOCUMENTS DOCUMENTS/VERIFICATION FORMS Valid Georgia State Driver’s License Verification of Automobile Insurance Automobile Insurance Declaration Page (100,000/300,000/100,000 with Medical) Copy of Social Security Card or # for payment Copy of Education Verification if High School or Paraprofessional (Diploma or Statement of Experience) Copy of Certified College/Graduate School Transcripts (with seal intact) Certifications/Current Professional License Professional Liability Insurance $1Million-$3Million Resume with 3-5 year Work History Satisfactory Results from GCIC and NCIC Live Scan Fingerprint Check W-2 Tax Form Independent Contractor Agreement (provided to you by Jireh)

COMPLETED

INITIALS