Class / Course Application

Personal Information

Name:

Phone Number:

Preferred Point of Contact

Phone Call

Text / SMS

Other

Address

This will be used purely for billing purposes.

*Note these trainings are based of Idaho laws and requirements, which varies per state.

Were you referred to us?

Education Level:

What course are you applying for?

The Following Questions are for those applying for the Peer and Family Support Course; if this does not apply to you, please move on to the next step and submit the form.

Do you have personal lived experience recovering from mental illness or mental illness with a co-occurring substance use disorder? if yes, please give a brief description.

How long have you been in a solid place with your recovery?

What does "recovery" meant to you?

Do you have experience raising a child with a behavioral and/or mental health disorder?

What resources and support systems have you utilized in your recovery (i.e. family and other natural supports, rehab, peer support, therapy)?

Do you have a solid self- care routine and/or practices? if so give a brief description.

How has recovery benefitted/changed your family dynamic?

What strengths do you bring as a CPSS or CFSP?

Can you provide at least two reference letters (these need to be from personal or professional references who can speak to your lived experience and attest to your potential to contribute positively to a community in the role of a Support Partner)?

If approved for class attendance, are you able to attend all 40 hours of training with no foreseeable absences?

Do you have a quiet space free from distraction & interruptions?

Do you have sufficient internet connection that will support multiple hours of consistent video conference utilization?

Are you currently employed at an agency that provides peer support services? If so, are they able to provide the required work/volunteer hours and supervision for your full certification?