NAMI Utah Teacher/Facilitator Application
We are delighted that you are interested in becoming a NAMI Utah teacher or facilitator! To be trained, you need to have attended the class or group you want to lead. Have you completed the course or are you willing to attend at least 3 support groups?
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Yes
No
Please read the program descriptions before selecting the program you're applying for:
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Connection Support Group: Ongoing recovery-based support group for those living with mental health conditions.
Family Support Group: Ongoing empowering support group for family members, partners, and friends of individuals living with mental health conditions.
Peer-to-Peer Course: 8-week course that encourages growth, healing, and recovery for adults with mental health conditions.
Family-to-Family Course:8-week course for family, partners, friends and significant others of adults living with mental illness. The course is designed to help family members understand and support their loved one living with a mental health condition, while maintaining their own well-being.
Basics Course: 6-week course for parents and other family caregivers of children and adolescents with mental health conditions who are looking for information on how to support and understand their child.
Progression Course:6-week course for youth who have a mental health condition. It is a safe place to learn about mental health conditions, diagnosis, triggers, treatments, stigma, self-care, and recovery. Must be age 18-28 years old to teach this program.
Part One
Today's Date
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Month
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Day
Year
Date
Name
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First Name
Last Name
What are your pronouns?
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Date of Birth
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Month
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Day
Year
Date
Age
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Email
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example@example.com
Phone Number
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Format: (000) 000-0000.
Mailing Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Languages Spoken
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Emergency Contact
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First Name
Last Name
Emergency Contact Phone Number
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Format: (000) 000-0000.
Part Two
Please tell us why you want to become a NAMI Teacher/Facilitator:
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If you have a mental health condition, how are you doing in your recovery right now?
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If this does not apply to you, write N/A
If you have a family member with a mental health condition, how are things now?
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If this does not apply to you, write N/A
Are you a member of NAMI?
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Yes
No
No, but I'm willing to join
Did someone from NAMI Utah refer you?
Yes
No
If so, who?
Do you give NAMI Utah permission to use pictures taken during training for marketing purposes (i.e. Facebook, Website, and Newsletter)
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Yes
No
Part Three
Expectations of NAMI Teachers / Support Group Facilitators:
Agree with and uphold the values of NAMI Utah Programs
Be or become a member of NAMI
Commit to a minimum of teaching two classes, or facilitating one support group (twice a month), per year
I have read and understand the expectations listed above:
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(Initial)
Applicant Signature:
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Submit
Should be Empty: