CPS CEU Submission Form

Please use this form to submit documentation of Continuing Education Units for CPS-MH
****Please Do Not Submit CEUs for 2025****

Certified Peer Specialists are required to complete and provide documentation for 12 Continuing Education Units each calendar year in order to maintain active certification. Six of those CEUs must come from a GMHCN sponsored training, workshop and or conference. For more information on CEU requirements, please visit our website.

Use this form to upload all of your CEU documentation. Please DO NOT submit documentation of CEUs via email. Any CEUs received via email as of August 15th, 2024 will not be accepted.

If you have questions, please contact:

Continuing Education Coordinator
Georgia Certified Peer Specialist Project
Phone: 404-687-9487
E-mail: ceu@gmhcn.org

*Please note, you are receiving this link to submit CEUS to reactivate your CPS Status
Contact Information
Full Name

PrefixFirst NameMI / MNLast Name
Date of Birth

MonthDayYear
Preferred E-Mail Address
example@example.com
Home Phone Number

Area CodePhone Number
Phone Number

Area CodePhone Number
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Please select the DBHDD Region that you reside in

Other
Demographic Information
Sex

Other
Race
CPS Training Cohort Number
Go to https://www.gmhcn.org/cps-training-schedule and move bottom to locate your Cohort Number
Employment Information
PEER EMPLOYMENT STATUS
* I am currently working as a Peer Specialist
Agency Name
Current Job Title
Work Telephone
Work E-Mail Address
Please select the DBHDD Region where you work, volunteer, and or provide services

Other
TRAINING ONE
Training One Title
Training One Facilitator
Training One Date (use first date of multi-day trainings)
Number of CEUs/Contact Hours for Training One
Upload supporting documentation for Training One by clicking the "Browse Files" button:

Browse Files

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- Training Two Title
- Training Two Facilitator
- Training Two Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Two
- Upload supporting documentation for Training Two by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Three Title
- Training Three Facilitator
- Training Three Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Three
- Upload supporting documentation for Training Three by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Four Title
- Training Four Facilitator
- Training Four Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Four
- Upload supporting documentation for Training Four by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Five Title
- Training Five Facilitator
- Training Five Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Five
- Upload supporting documentation for Training Five by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Six Title
- Training Six Facilitator
- Training Six Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Six
- Upload supporting documentation for Training Six by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Seven Title
- Training Seven Facilitator
- Training Seven Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Seven
- Upload supporting documentation for Training Seven by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Eight Title
- Training Eight Facilitator
- Training Eight Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Eight
- Upload supporting documentation for Training Eight by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Nine Title
- Training Nine Facilitator
- Training Nine Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Nine
- Upload supporting documentation for Training Nine by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Ten Title
- Training Ten Facilitator
- Training Ten Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Ten
- Upload supporting documentation for Training Ten by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Eleven Title
- Training Eleven Facilitator
- Training Eleven Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Eleven
- Upload supporting documentation for Training Eleven by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Twelve Title
- Training Twelve Facilitator
- Training Twelve Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Twelve Thirteen
- Upload supporting documentation for Training Twelve by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Thirteen Title
- Training Thirteen Facilitator
- Training Thirteen Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Thirteen
- Upload supporting documentation for Training Thirteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Fourteen Title
- Training Fourteen Facilitator
- Training Fourteen Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Fourteen
- Upload supporting documentation for Training Fourteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Fifteen Title
- Training Fifteen Facilitator
- Training Fifteen Date (use first date of multi-day trainings)
- Number of CEUs/Contact Hours for Training Fifteen
- Upload supporting documentation for Training Fifteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Sixteen Title
- Training Sixteen Facilitator
- Number of CEUs/Contact Hours for Training Sixteen
- Training Sixteen Date (use first date of multi-day trainings)
- Upload supporting documentation for Training Sixteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Seventeen Title
- Training Seventeen Facilitator
- Number of CEUs/Contact Hours for Training Seventeen
- Training Seventeen Date (use first date of multi-day trainings)
- Upload supporting documentation for Training Seventeen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Eighteen Title
- Training Eighteen Facilitator
- Number of CEUs/Contact Hours for Training Eighteen
- Training Eighteen Date (use first date of multi-day trainings)
- Upload supporting documentation for Training Eighteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Nineteen Title
- Training Nineteen Facilitator
- Number of CEUs/Contact Hours for Training Nineteen
- Training Nineteen Date (use first date of multi-day trainings)
- Upload supporting documentation for Training Nineteen by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- Training Twenty Title
- Training Twenty Facilitator
- Number of CEUs/Contact Hours for Training Twenty
- Training Twenty Date (use first date of multi-day trainings)
- Upload supporting documentation for Training Twenty by clicking the "Browse Files" button:
  
  Browse Files
  
  Cancelof
- I understand that Georgia Certified Peer Specialists work from the perspective of their lived experience with recovery from a mental health diagnosis . I agree to be open about the fact that I have been diagnosed with a behavioral health concern, and to use my lived experience to support other peers along their recovery journeys. I understand that in doing so I help educate others about the reality of recovery.
- I am in recovery from mental health or mental health and substance use concerns.
- By printing and signing your full name below, you confirm that the information submitted on this application is true and accurate, and acknowledge that the CPS Project may terminate your participation in the CPS Project training, or revoke your certification (if received) at any time, if it is determined that false information was supplied on this form.
- Print your full name here:
- Signature
- You will receive a confirmation response after you click the "Submit My CEUs" button that will indicate that your submission has been received. You will also receive a confirmation email from the Georgia CPS Project which will be sent to the "preferred email" that you entered in your application.

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Contact Information

Demographic Information

Employment Information

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