Application for Peer Recovery Training Scholarship Fund

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

In order to be considered for a scholarship for a peer recovery training, you must complete this form. Please submit the form at least 3 weeks before the training you would like to attend to allow time for review of your application. It is important to remember that applying for a scholarship does not mean you will be approved for it.

Email *

What is your full name? *

How old are you?

Please provide your phone number. *

Please provide your email address. *

What training are you requesting funds for? If there is a link with more information, please include it. If there is not a link please provide all the information you have on the training. (such as title, when it is being held, cost, how to submit payment for the training)

What is the cost of the training?

Why do you want to take this training? This information will help the state better understanding training needs of PRS.

What is your Peer Recovery Specialist certification number from the RI Certification Board? (If you do not have a peer recovery certification, please respond NA)

Are you working towards a PRS certification from RICB?
*

Yes

I am already certified.

Are you currently employed? *

Yes

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms