Peer Professional Supervision **VIRTUAL** 4/21/2022

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Date: Apr 21, 2022 - Apr 22, 2022 Time: 10:00 am - 5:00 pm
Status: Open Registration Deadline: Apr 19, 2022
Trainers Name: Aloysius Joseph Training Site: PARC Queens Address:
92-13 147th Place (lower level) Jamaica, New York 11435 Queens County

Credit Hours: 12 Credit Types: CRPA AND CARC RENEWAL CREDITS Cost: $300 Manuals: Included Schedule:

Training is held virtually Via Zoom Thursday April 21st and Friday April 22nd 2022 from 10am to 5pm. Punctuality is important!

Additional Information:

Training is held virtually Via Zoom Thursday April 21st and Friday April 22nd 2022 from 10am to 5pm. Punctuality is important!

Contact Name: Patricia Benecke Contact Phone Number: (929) 244-1445 Contact Email Address: [email protected]

Candidate Information
Name*
First Last
Title
Organization*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone Number*
Fax Number
Role with Organization*
- Volunteer
- Staff
- Other
Please Specify Role*
Candidate Plan
Briefly describe your professional experience with addiction recovery, if relevant*
Briefly describe your personal and/or family history with addiction recovery, if relevant*
Explain why you are interested in this training and how you will use it*
Organization Plan
Explain why your organization/agency is interested in this training*
How will this training be used in the delivery of services? Please be specific in describing how you utilize peer recovery coaches*
In a few sentences, describe why your agency/organization is well qualified to integrate the use of peer recovery coaches and/or this training this time*
TOT
Are you applying for the TOT?*
- Yes
- No
- Not Applicable
Please describe your training qualifications and give examples of the trainings you have delivered along with two references*
Please describe how your organization will use your ability to train recovery coaches*
Name
This field is for validation purposes and should be left unchanged.

Peer Professional Supervision **VIRTUAL** 4/21/2022

Candidate Information

Candidate Plan

Organization Plan

TOT

Peer Professional Supervision VIRTUAL 4/21/2022