Certified Peer Recovery Specialist (CPRS) Integrated Training Registration
RequiredRequired Question(s)
Welcome!

This application is for Integrated Mental Health and Substance Use Peer Recovery Specialist 46-hour Certificate Training endorsed by the RI Certification Board. This training program coordinated by Peers4Recovery at Parent Support Network of RI. 

This application should take approx. 5-10 minutes to complete. You will be asked to provide information including your contact information, race/ethnicity, education, citizenship, computer skills, lived experience, previous training programs, transportation options, and any special accommodations you may need to take the training. You will also be asked to write a short paragraph on what recovery means to you. After you complete the application, you will receive a confirmation that the application was received, and may be contacted for a follow-up interview.

If you have any questions about the application process or the Certified Peer Recovery Specialist (CPRS) training program, please call (401) 889-3112 or email e.goodman@psnri.org.

Thank you for your time and interest in CPRS Training. We look forward to talking to you soon!
 
Required 1.
Please enter the information indicated below.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.
What is your Date of Birth?
 

50 characters left.
Required 3.
What is your race/ethnicity? (check all that apply)
Asian
American Indian or Alaska Native
Black or African-American
Hispanic or Latino/a
Native Hawaiian or Pacific Islander
White
Other  
  • Comment:

  • 500 characters left.
Required 4.
Which of the following languages do you speak fluently? (check all that apply)
English
Spanish
French
Portuguese
Laotian
Cambodian
American Sign Language
Other  
  • Comment:

  • 500 characters left.
Required 5.

What is the highest grade level of education you've completed? 

Grades 1 through 8 (Elementary)
Grades 9 through 11 (Some High School)
Grade 12 or GED (High School Graduate)
Vocational/Technical Diploma after High School
Some College or University
Bachelor's Degree (BA/BS)
Master's Degree or Higher
I've never attended School or a Job Training Program
Required 6.

Are you a Citizen of the United States? 

Yes
Citizenship Application in process
No
Required 7.
Are you currently employed?
Yes
No
Other  
  • Comment:

  • 500 characters left.
Required 8.
Do you participate in any volunteer work?
Yes
No
Other  
  • Comment:

  • 500 characters left.
Required 9.

Are you currently a Student?

Yes
No
Other  
  • Comment:

  • 500 characters left.
Required 10.
Which of the following computer skills do you have? (Check all that apply)
Email
Navigating the Internet
Data Entry
Online Education
None - I have no computer skills
Other  
  • Comment:

  • 500 characters left.
Required 11.
In order to be certified as a Peer Specialist, the State of Rhode Island requires that a person have the lived experience of mental illness, addiction, homelessness, or lived experience with a family member who has one of these issues. Do you have lived experience?
Yes
No
12.
If you answered "Yes" to Question #11, which of the following lived experiences do you have? (Check all that apply.)
Self - Mental Illness
Self - Addiction
Self - Homelessness
Family - Mental Illness
Family - Addiction
Family - Homelessness
Other  
  • Comment:

  • 500 characters left.
13.

If you answered "No" to Question #11, which of the following  best applies to you?

Healthcare Provider
Counselor
Ally
Student
Volunteer
Other  
  • Comment:

  • 500 characters left.
14.
Sharing our stories of lived experience is an important part of the work of a Peer Recovery Specialist, and learning how to do so appropriately and effectively is included in the CPRS Training.

If you answered "Yes" to Question 11, would you be willing to share your personal experience with your or your family member's recovery?
Yes
No
Required 15.
In your own words, what does recovery mean to you? Please include 2-3 sentences.  
 

1000 characters left.
Required 16.
Do you hope to become certified OR employed as a Peer Recovery Specialist in the future?
Yes
No
Other  
Required 17.
Which of the following recovery trainings have you participated in previously? (Check all that apply.)
Substance Use
Mental Health
Recovery Coach / Peer Recovery Specialist
Wellness
None
Other  
  • Comment:

  • 500 characters left.
Required 18.
Do you currently have a valid driver's license? (Please note that a driver's license is not mandatory for certification, but may required by some employers.)
Yes
No
Required 19.

If selected for the training, will you be able to arrange your own transportation (personal or public)? 

Yes
No
Required 20.

We offer CPRS trainings at multiple times / locations. Please select the options below that would work for your schedule. (Check all that apply. Feel free to give more information in comments.)

X
X
AMOS HOUSE -- PROVIDENCE
X
X
X
  • Comment:

  • 500 characters left.
21.

Please describe any special accommodations you may need for the training.

 

350 characters left.
Required 22.

How did you hear about this training?

 

350 characters left.
23.

Is there anything else you would like to add?

 

350 characters left.