CMWN Peer Support Professional Training Application

Peer Support Professional Virtual Training Application
Please review and fill out each section of this application. If you have any questions, please reach out to us via email.

Once you’ve completed your application, be sure to click “submit”. You should receive a confirmation email as well as a copy of your answers if you’ve successfully submitted your application

In order for us to process your application, you must submit both your application and your letter of reference by the application deadline. Please check our website for deadline dates. If we receive your application after the deadline, we can consider it for our next available training.
Full Name*

First NameLast Name
Current Address*

Street Address

Street Address Line 2

CityState

Zip Code
Personal Email Address*
Would you like to subscribe to the CMWN Newsletter?

Yes, subscribe me to the CMWN Newsletter
Work Email Address
Phone Number*
I would prefer to be contacted about my application status via: *
Are you applying for the next available training?*

YesNo
If no, please write in the date of the training you are applying for.

EMPLOYMENT AND VOLUNTEER INFORMATION

Please review the following employment/volunteer questions and answer them out as they apply to you. If you answer “no” to any of the questions, you can move on to the next section of the application.
Are you currently working in a peer support role?*

YesNo
If yes, please fill out the following. *
Have you been offered a job in a peer support role?*

YesNo
If yes, please fill out the following. *
Are you currently volunteering in a peer support capacity?*

YesNo
If yes, please fill out the following. *

APPLICATION QUESTIONS
Why are you interested in working or volunteering as a Peer Support Professional?*
Why are you interested in attending this specific Peer Support Professional Training through CMWN?*
What does recovery mean to you in your own life? *
Why do you think you are a good candidate to provide support to your peers in their recovery journey?*
Do you have a written plan for your own wellness and recovery? Please write yes or no. If yes, please give details on how and when you developed your plan and how it has helped you. *
How do you practice wellness in your daily life? Please provide examples of recovery and wellness tools, skills, resources, or strategies that you use. *
What are your strengths and how will they help you as a Peer Support Professional? *
What experience (if any) do you have providing peer support or advocating for peers with mental health and/or substance use conditions? *
Please describe how you deal with stressors. *
What skills would you like to improve through the Peer Support Professional training? *
Peer Professional training is demanding. This is not a webinar. Class runs from 8:30 – 5 each day. Your participation is required. There are projects to complete as well as daily reading and homework. What will be your most difficult challenge(s) in attending this training AND how do you plan to deal with them? *
Please list any social, religious, civic, fraternal, voluntary, or other organizations that you are affiliated with and any leadership positions you have held within them. *
Please list any other education or training that you have that may assist you in a Peer Support Professional role. *

TRAINING EXPECTATION AGREEMENT
If you are accepted into the Peer Support Professional Training Program, we want you to know up front what is expected of you to make sure this training is a good fit.

Training actually begins the week before the first classroom date. Audios and videos along with study guides are sent the week before and are due the first day of class.

Please read over the expectations, check each as you agree, and sign at the bottom.
If I am accepted into this training program, I will:*
I certify that:*

I have completed this application on my ownEverything I have written in this application is true at the time of this application, and that if any of these statements are no longer true, I will notify staff members at CMWN
Signature*

Clear
Date

MonthDayYear
Date

TUITION AND INVOICING
Once accepted into the program, a tuition invoice will be sent to you or your sponsoring organization. The invoice includes a non-refundable deposit which is required to reserve your place in the training. This deposit is applied to your tuition. To see current tuition rates, please visit our application page.

Please indicate who the tuition invoice should be sent to if accepted into the program. If funding is coming from multiple sources, please select each source and fill out relevant information, as well as indicating how much each funding source is contributing to your tuition.
How will your tuition be paid?

Self PayDivision of Vocational RehabilitationEmployer or other Organization
Division of Vocational Rehabilitation
Employer or other Organization
Status
Interviewer
TERMS
I understand that, if accepted:*

If I am paying for tuition myself, I will be required to place a non-refundable deposit to hold my place in the class once an invoice is received.If I am being sponsored by an employer or other organization, they will be required to pay the tuition in full once an invoice is received.If my tuition is partially paid via employer sponsorship, I am personally responsible for any remaining balance.Tuition must be paid in full by the first day of training unless a payment plan arrangement has been establish through communication with CMWN.Training certificates cannot be released until tuition is paid in full.

NEXT STEPS
Please review and submit your application.

If you choose to print, you will still need to click the submit button after!
Should be Empty:

Peer Support Professional Virtual Training Application

QUALIFYING QUESTIONS

EMPLOYMENT AND VOLUNTEER INFORMATION

APPLICATION QUESTIONS

TRAINING EXPECTATION AGREEMENT

TUITION AND INVOICING

Please indicate who the tuition invoice should be sent to if accepted into the program. If funding is coming from multiple sources, please select each source and fill out relevant information, as well as indicating how much each funding source is contributing to your tuition.

TERMS

NEXT STEPS