APPLICATION FOR CERTIFICATION
OREGON ASSOCIATION OF COUNTY TREASURERS
AND FINANCE OFFICERS
GENERAL REQUIREMENTS FOR CERTIFICATION:
In order to receive a certificate of completion from the OACTFO, applicants
must successfully complete BOTH the education and experience
components.
To apply for this certificate, you must do the following:
1) Execute the attached affidavit. Applicants are responsible for keeping their
own records. This affidavit must be signed by you.
2) Send these to:
Barbara Hoffstetter, Training & Employee Development
Mt. Hood Community college
26000 S E Stark St
Gresham, Oregon 97030
Other communications information for Ms. Hoffstetter:
Phone: (503) 491-7386 Fax: (503) 491-7390
E-mail: hoffsteb@mhcc.cc.or.us
3) A check for $45.00, payable to Mt. Hood Community college, must
accompany your application.
4) All applications must be received on or before June 15 for September
certification.
APPLICANT INFORMATION
1.
Doe
Last Name
2.
Treasurer
Title
3.
Jane
First
I.
Initial
Any
County
123 Main Street
Mailing Address
4.
City
State
Zip Code
5.
Business Phone
Home Phone
Fax
6.
Home Address
E-mail
7.
City
State
Zip Code
AFFIDAVIT
I, (sign your name here)
, do hereby apply for certification under the
Oregon Association of County Treasurers and Finance Officers training and
certification program.
I further affirm that I have completed the practical experience component as
listed below:
1. Experience as a full-time county official (4 points for each year served,
maximum of 25).
Position
County
Years Served
Treasurer
Any
2002-2006
Tax Collector
Any
2002-2003
Subtotal
25
2. Other supervisory positions in local government prior to becoming a county
official (2 points for each year served, maximum of 10).
Position
County
Years Served
Deputy Treasurer
Any
1999-2002
Subtotal
8
3. Supervisory position in federal, state or other local government (1 point for
each year served, maximum of 10).
Position
Agency
Years Served
Subtotal
4. Certification by national or state recognized organization (e.g. CMA, CPA,
CIM) (10 points per certification, maximum of 20).
Organization
Date of Certification
Subtotal
5. Attendance at an annual national or state convention for your respective
affiliate association (1 point per convention, maximum of 20).
Convention
Sponsor
Place
Date
OMFOA
OMFOA
Salishan, OR
3/2004
OMFOA
OMFOA
Sunriver, OR
3/2005
GIOA
GIOA
Las Vegas, NV
3/2006
OACTC
OACTC
Seaside, OR
7/2002
Subtotal
4
6. Attendance at the OACTFO Annual Convention (1 point per convention,
maximum of 10).
Date
Place
9/02
Portland
9/03
Beaverton
9/04
Hood River
9/05
Boardman
Subtotal
4
7. Service as an officer or statewide committee chairperson in your respective
affiliate association (2 points for each year served, maximum of 10).
Office
Association
Dates Served
Secretary/Treasurer
OACTFO
President-elect
OACTFO
Chair of Manual Committee
OACTFO
2004/2005
2005/2006
2004/2005
Subtotal
8
8. Service as an officer or committee chairperson in a national association
related to your county office (2 points for each year served, maximum of 10).
Office
Association
Dates Served
Subtotal
9. Service as a speaker, panel member or instructor at an annual job-related
convention or course of professional instruction (1 point per course per year,
maximum of 10).
Course
Sponsor
Date
Treasurer’s Treasury
OACTFO
9/2004
Performance Measures
OACTFO
9/2005
Subtotal
2
10. Education courses and in-service training related to your position as a county
official (1 point per course and each course must represent 6 hours of
training, maximum of 10).
(For courses and in-service training which require the taking and successful
passage of a test, students who receive a passing grade will receive 2 points
per course, but students failing the test shall receive no points.)
Course
Sponsor
Date
See attached sheets
Subtotal
10
11. Relevant university or college course work and/or correspondence courses
offered by an accredited institution of higher education or similar organization
of recognized merit (1 point per credit hour, maximum of 25).
(Students must submit a copy of their school transcript)
Course
Institution
Dates of Completion
Psychology in the Workplace
American Government
Accounting 101
Chemeketa
Chemeketa
Chemeketa
Spring 2003 (4 credits)
Fall 2003
(3 credits)
Spring 2005 (4 credits)
Subtotal
12
Total number of experience points earned (50 points are required for
certification).
TOTAL
73