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Peer Training Application

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

Personal Information

Name
MM slash DD slash YYYY
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 Address
Did you graduate?

Address
Did you graduate?

References

Name

Name

Name

Disclaimer and Signature

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

MM slash DD slash YYYY

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