ApplicationPlease enable JavaScript in your browser to complete this form.Legal Name (as on your ID) *FirstLastPreferred Name Preferred PronounsPrimary Phone Number *Social Security Number or Worker ID Number *Mailing Address *City, State, ZIP *Email (to be used for all class-related contact) *EmailConfirm EmailWhich class session are you applying for? *July 7, 14, 21, 28, & Aug. 4 2023October 6, 13, 20, 27, Nov. 3 2023What format are you planning to attend in? *via Zoomin the CMI Boise officeAre you at least 18 years of age? *YesNoDo you identify as someone in ongoing recovery from mental illness or co-occurring disorder (mental illness + substance use disorder) for at least one year? *YesNoDo you have a high school diploma, GED, or higher education, and the ability to provide documentation of your education when applying for certification? *YesNoAre you willing to share your experience with mental illness and recovery with co-workers and peers? *YesNoDo you have a genuine desire and commitment to help others with their own recovery? *YesNoDo you feel capable of setting healthy boundaries and letting go of responsibility or obligation for the behavior and choices of those you work with? *YesNoAre you willing and able to work as a team member with other mental health providers? *YesNoDo 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 internetYes, in person in BoiseNoIf attending via Zoom, will you be able to attend the class from a reasonably private area for the full required time each training day? *YesNoI have read and agree to abide by the Idaho Certified Peer Support Specialist Code of Ethics, *YesNoI understand that, if accepted for training, I will be required to provide a photocopy of my government-issued photo identification to CMI. *YesNoI understand that, if accepted for training, I will be expected to attend and participate for the full 40 hours of the class. *YesNoI 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. *YesNoI 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. *YesNoI 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. *YesNoI 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. *YesNoDo you anticipate needing any special accommodations for completing the course or final exam? YesNoI understand that it is my responsibility to apply for certification with BPA after successfully passing the training course. *YesNoI understand that successful completion of this course does not guarantee certification or employment. *YesNoI understand that, while working in this field, most paid time is by the billable hour. *YesNoI understand that most peer support employment will require that I have access to reliable and legal transportation. *YesNoI understand that employment as a peer support specialist generally requires that I pass an enhanced criminal background check. *YesNoI understand that writing, reading, and working on a computer are generally necessary for working as a peer support specialist. *YesNoIf accepted, what funding source do you hope to use? *SelfEmployerVocRehabOtherIf accepted, can you access the Boise office or do you need your materials shipped to you for an additional $25? *Boise OfficeShip to me for an additional $25I have read and verify that I understand the Peer Support Training Readiness guide from this website. *YesNoWhere did you hear about us?Submit