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Peer Recovery Coach Scholarship Application
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Are you a person in recovery?
*
Yes
No
If you answered "No" to the above question, what is your lived experience with Mental Health or Substance Use Disorder?
*
Your answer
What is your continuous length of sobriety?
*
Your answer
Are you currently employed?
*
Yes
No
If employed, what industry do you currently work in? Type N/A if you are not currently employed.
*
Your answer
This class is intense and extensive. You are required to attend all trainings for their entirety.
Please think about this. Do you have the time for this training right now?
*
Yes
No
If you receive the scholarship, would you be willing to volunteer your time within our community?
*
Yes
No
What do you hope to gain from this course?
*
Your answer
What are your future career plans in relation to taking this course?
*
Your answer
Why are you asking for a scholarship?
*
Your answer
Thank you for your application.
I receive many emails. Please be patient. If you have not received a response within 14 days, check on the receipt of your application by calling
719-232-7221
or emailing
academy@hazelbrook.org
A copy of your responses will be emailed to the address you provided.
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