Application | Peer Support Training

Legal Name (as on your ID)

First

Last

Preferred Name

understand hear I

Preferred Pronouns

Phone Number

Social Security Number or Worker ID Number

Mailing Address

City

State

ZIP Code

Email (to be used for all class-related contact)

Confirm Email

What format are you planning to attend in?

via Zoom
in the CMI Boise office

Are you at least 18 years of age?

Yes
No

Do you identify as someone in ongoing recovery from mental illness or co-occurring disorder (mental illness + substance use disorder) for at least one year?

Yes
No

Do you have a high school diploma, GED, or higher education, and the ability to provide documentation of your education when applying for certification?

Yes
No

Are you willing to share your experience with mental illness and recovery with co-workers and peers?

Yes
No

Do you have a genuine desire and commitment to help others with their own recovery?

Yes
No

Do you feel capable of setting healthy boundaries and letting go of responsibility or obligation for the behavior and choices of those you work with?

Yes
No

Are you willing and able to work as a team member with other mental health providers?

Yes
No

Do you have access to a computer with a webcam, microphone, and high-speed internet connection, or prefer to attend a class in person at our Boise office?

Yes, computer, webcam, and internet
Yes, in person in Boise
No

If attending via Zoom, will you be able to attend the class from a reasonably private area for the full required time each training day?

Yes
No

I have read and agree to abide by the Idaho Certified Peer Support Specialist Code of Ethics

Yes
No

I understand that, if accepted for training, I will be required to provide a photocopy of my government-issued photo identification to CMI.

Yes
No

I understand that, if accepted for training, I will be expected to attend and participate for the full 40 hours of the class.

Yes
No

I agree, if accepted for training, to communicate any barriers or emergencies that affect my ability to attend or participate in class effectively to the facilitators immediately.

Yes
No

I understand that completing this application only begins the process, and I will also need to submit 2 letters of recommendation (outlined in the Readiness Guide), a lived experience essay, and participate in a video interview via Zoom before being accepted into the course.

Yes
No

I understand that, if accepted into this training, my payment will be due no later than 8 days before training begins and I will not receive my training materials until payment is received.

Yes
No

I understand that, by state requirements, an 80% or better is required for successful class completion, and of that score, 3/4 will be from the exam and 1/4 will be from participation.

Yes
No

Do you anticipate needing any special accommodations for completing the course or final exam?

Yes
No

I understand that it is my responsibility to apply for certification with BPA after successfully passing the training course

Yes
No

I understand that successful completion of this course does not guarantee certification or employment.

Yes
No

I understand that, while working in this field, most paid time is by the billable hour.

Yes
No

I understand that most peer support employment will require that I have access to reliable and legal transportation.

Yes
No

I understand that employment as a peer support specialist generally requires that I pass an enhanced criminal background check.

Yes
No

I understand that writing, reading, and working on a computer are generally necessary for working as a peer support specialist.

Yes
No

If accepted, what funding source do you hope to use?

Self
Employer
VocRehab
Other

If accepted, can you access the Boise office or do you need your materials shipped to you for an additional $25?

Yes, I will pick up my book
No, ship to me for an additional $25

I have read and verify that I understand the Peer Support Training Readiness guide from this website.

Yes
No

Where did you hear about us?