November 3rd - 7th, 2025
Peer Recovery Support Specialist Training Application
Thank you for your interest in becoming a Peer Recovery Specialist! This training is designed for individuals in recovery who are interested in using their lived experience to support others on their recovery journey and meets one of the requirements towards becoming certified as a peer in Minnesota and building a career as a CPRS. Please complete the following application and submit on or before the application deadline for the training you are applying for.
Contact Information
Name
*
First Name
Last Name
Preferred Name (if different)
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Eligibility
Family members and recovery allies are welcome to take this training, but only those with lived experience in SUD are eligible to become certified as a CPRS in Minnesota.
Are you currently in recovery from substance use disorder?
*
Yes
No
If applicable, how long have you been in recovery?
Less than 1 year
1-2 years
2-5 years
More than 5 years
If you were referred by someone, please enter their name below:
Training Interest and Experience
Why are you interested in becoming a Peer Recovery Support Specialist?
*
Have you ever received peer support services yourself?
*
Yes
No
Do you currently work or volunteer in the recovery or behavioral health field?
*
Yes
No
If yes, please describe
Demographics
Age
Race/Ethnicity
Gender Identity
Are You Now or have You Ever Been Justice-Involved?
Yes
No
Prefer not to say
Are you a veteran?
Yes
No
Prefer not to say
Have you ever experienced homelessness?
Yes
No
If you answered yes to the above question, how recently?
Less than 1 year ago
1-5 years ago
5 or more years ago
Training Logistics
Do you need any accommodations to participate in the training?
Which group interview would you like to attend?
*
10/21/2025 at 4:00pm (Virtual)
10/22/2025 at 10:00am (Virtual)
If you cannot attend either session, please contact Derek Johnson by 10/19 at Derek@amethystrecoverysolutions.org to make other arrangements.
You are required to submit two letters of recommendation to complete your application.
The recommendation form (along with instructions and more info) can be found on the Amethyst Recovery Academy main page.
How many recommendation forms were submitted for you? (2 recommendation forms are required, so if you are not selecting "2" here, please get the forms submitted to complete the application process.)
*
0
1
2
How will you be paying for this training?
*
Please Select
Paying myself
Another organization is paying
Being paid for by tribe/church/other entity
Other
If "Other" is selected above, please explain
How did you hear about this training? Please be specific, as any details might help us with effective communication and marketing.
*
Signature
By submitting this application, I affirm that the information provided is true and accurate to the best of my knowledge.
Name (Typed)
*
Signature
*
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