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Welcome
Please fill out and submit this form to register for the training CRS Ethics Training
8
Questions
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1
I understand that this training is structured for Certified Recovery Specialists/Certified Peers.
*
This field is required.
If not a CRS/CRFS or in the process of becoming one, you will be placed on a waitlist and emailed the week prior to let you know whether or not there are open seats.
YES
NO
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2
Name
*
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First Name
Last Name
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3
Email
*
This field is required.
example@example.com
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4
Phone Number
*
This field is required.
Please enter a valid phone number.
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5
Are you a CRS or CFRS who was certified through the PA Certification Board?
*
This field is required.
Yes
No
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6
If you are not a CRS/CFRS what is your credentials and/or job title?
Indicate if you are working towards becoming a CRS/CFRS- You are NOT required to be a CRS for this training
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7
I work with
*
This field is required.
SCA
Treatment Provider
Recovery Organization
Recovery Community Center
Other
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8
I work in the following counties
*
This field is required.
Bradford
Centre
Clinton
Columbia
Lycoming
Montour
Northumberland
Potter
Snyder
Sullivan
Tioga
Union
Other
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