Peer Training Application

CHCSBC Peer training Application Form

For assistance completing this application, please contact the CHCS Peer Services Team at 210-261-1103.

Personal Information

Name
Date
Address
Training(Required)
Have you completed the Peer Orientation and Self-Assessment?
Do you identify as a person who has personal lived experience with substance use and/or mental health recovery?
Do you have significant experience working on your own recovery?

Education

Address
Did you graduate?

College

College Address
Did you graduate?

Other

Address
Did you graduate?

Reference 1

Name

Reference 2

Name

Reference 3

Name

Disclaimer and Signature

I certify that my answers are true and complete to the best of my knowledge.

Full Name (Electronic Signature)
Agreement
Date