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S TATE G OVERNMENT A FFAIRS C OUNCIL T: 703-684-0967

515 K ING S TREET , S UITE 325 F: 703-684-0968


A LEXANDRIA , VA 22314 W : WWW . SGAC . ORG

S TATE G OVERNMENT A FFAIRS P ROFESSIONAL


C ERTIFICATE P ROGRAM A PPLICATION
SGAC G UIDELINES
FOR P ROFESSIONAL C ONDUCT
Candidate Information:
Candidate Name ____________________________________________ SGAC believes government affairs profes-
sionals should uphold the highest standards of
Title/Responsibilities ________________________________________ ethical behavior. In that regard, SGAC
expects its members and State Government
________________________________________________________ Affairs Professional Certificate Program
candidates to adhere to the following guide-
Member/Organization Name ___________________________________ lines:

Address __________________________________________________ • Members will comply with both the


letter and the spirit of all applicable
City/State/Zip _____________________________________________ laws regarding lobbying, campaign
finance, political activities and business-
Phone ________________________ Fax ________________________ government relations.

E-mail ____________________________________________________ • Members will represent the interests of


their employer or client in an honest,
open fashion, avoiding the intentional
dissemination of false or misleading
Educational Requirements: information to clients or employers,
public officials, the media or profes-
All candidates must have a bachelors degree and either a J.D. or Masters/Ph. D. in a sional colleagues.
related field or a minimum of 3 years experience in a policy or government affairs-
related field. Please check all that apply. • Members will treat all involved in the
governmental process with full respect
and dignity.
Bachelors Degree
• Members will avoid conflicts of interest
School/Year:___________________________________________ and where conflict is unavoidable, will
communicate the facts fully and freely
J.D. or Masters/Ph.D. in Related Field to those affected.
Explain: ______________________________________________ • Members will strive to increase public
understanding of the role of advocacy
Minimum 3 years experience in a policy or government affairs-related field in a representative democracy through
individual and collective educational
Explain: ______________________________________________ efforts.

• Members will continue to pursue pro-


fessional development through formal
education, meetings and seminars, and
Fee inFormation: any other means available to acquire
enough knowledge to fairly present a
A one-time, nonrefundable filing fee of $175 must be submitted with your balanced point of view.
application.
• Members will respect and abide by the
Total Due ___________________________________ applicable rules, regulations and prac-
AMEX tices of national and regional organiza-
Credit Card Number ___________________________ tions of state government officials.
MasterCard
Expiration Date _______________________________ My signature below confirms that I, as a State
VISA Government Affairs Professional Certificate Program
Cardholder Name _____________________________ candidate, have reviewed and acknowledge the
SGAC Guidelines for Professional Conduct and have
Cardholder Signature ___________________________ submitted information on this application that is
true and correct.
If you would like to submit your fee payment by check, please write your check to the
State Government Affairs Council (SGAC) and mail it to 515 King Street, Suite 325, Signature _____________________
Alexandria, VA 22314. Date ________________________