Application - Peer Support Training

Legal Name (as on your ID) *

First

Last

Preferred Name

Preferred Pronouns

Primary Phone Number *

Social Security Number or Worker ID Number *

Mailing Address *

City, State, ZIP *

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

Email

Confirm Email

Which class session are you applying for? *

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? *

Boise Office
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?