NAMI Vet Connect Facilitator Application:  
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Application for NAMI Vet Connect  to be completed by the applicant. 

NAMI Vet Connect is for veterans dealing with the challenges of living with a mental health condition. NAMI Vet Connect is veteran peer lead by individuals with mental health conditions and offer hope to those participating. NAMI Vet Connect facilitators must be willing to share their perspectives as someone living with a mental health condition and listen empathically to others as they share their stories.  In order to become a facilitator, one MUST

* be a veteran

* have a mental health condition

* successfully complete 16 hours of training and receive a facilitator certification.  Weekend Zoom Training Available Sat & Sun 9:00 - 5:00 PM. Dates TBD.

If you are interested in becoming a NAMI Vet Connect facilitator and you meet the above criteria, please proceed to the next section to begin your application.

Date *
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Name *
Email *
Address *
Phone Number *
To protect our online meeting trainees, we ask all participants to provide us with an emergency contact person that we could contact ONLY in the event of an emergency. This information is kept completely confidential - it will never be sold or shared. 
Emergency Contact 
Name, Relationship, Email and Phone Number
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All NAMI Program Leaders must be current members. Are you a member of NAMI?
 *
If yes, which affiliate ?
Your answer

If yes, which affiliate ?
Your answer

If you are not a current member, please join the NAMI Okaloosa Walton Membership after submitting this application.  Please visit www.NAMI.org and join under the 32459 zip code.
Have you participated in 3 or more NAMI Connection Recovery Support Group?
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I prefer to facilitate: *
I am available to facilitate: *
Do you have a mental health condition?
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Why do you want to become a NAMI Vet Connect Facilitator? 
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What does recovery mean to you?
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What are your views on mental health treatment (medication, traditional, non-traditional)?
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I understand that all NAMI programs are copyrighted. I will adhere to the Program Operating Policies and Conduct of Conduct, and I will present according to these policies at all times.  


I understand that my attendance at the NAMI Connection Facilitator Training does not guarantee that I will be certified as a Connection Facilitator. If I receive facilitator certification, I understand/agree to serve as a leader in twelve support group meetings during a two-year commitment, or close to these time limits. The time, energy and expense of training each facilitator make this a necessity. It is understood, of course, that unexpected situations may occur that will necessitate compassion and flexibility in this policy. 

I agree to only use approved NAMI Connection materials that are provided in my Leader Manual. I also agree to send all reports to the local NAMI Affiliate Program Coordinator and to the NAMI State Program Director.

Please indicate by typing your name and date.
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We may need to conduct a brief interview with you. Please list the best days and times.

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