Family Coaching Training Application

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Please complete the form below. Upon acceptance into the training, you will receive training login details via email. Thanks for applying!

What is the first day of the training you are interested in attending? *

YYYY

First Name *

Last Name *

Name as you would like it to appear on your certificate of completion *

Are you an IC&RC Certified Recovery Coach? *

Yes

Email *

Phone Number *

Street Address *

Street Address Line 2

City *

State *

County *

Zip Code *

What Recovery Center do you work with? *

If other, where are you working or volunteering? *

Have you completed the Vermont Recovery Coach Academy? *

Yes

If yes, when did you complete the Academy? *

Does your supervisor formally recommend your attendance at the Family Coaching training? *

Yes

Supervisor's Name *

Supervisor's Email *

Supervisor's Phone Number *

How did you hear about this training? *

What do you hope to learn from this training? (there are no wrong answers!)
*

Do you require any special accommodations and/or would you like the facilitator to know anything about your needs and/or learning styles?
*

Submit

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This form was created inside of The Vermont Association for Mental Health and Addiction Recovery. Report Abuse