This form will collect basic information from you about you, your reasons for seeking certification, and your affiliation with Georgetown University. It will also provide you with the relevant information about the University's Protection of Minors policy, information on determining and reporting known or suspected abuse, guidelines for interacting with minors as part of a University-run or -affiliated program, as well as information about the University's bullying prevention policy.

At the conclusion, you will confirm that you have read and understood the contents of the survey.