NAMI Wisconsin
Peer Support Group Facilitator Training
Date: August 10 -11, 2019
Location: NAMI Wisconsin Office

This form must be completed by July 10, 2019.

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* 1. General Information

Please sign your initials in agreement next to each of the following statements:

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* 2. I understand that Peer Support Group is a NAMI Wisconsin program, and not a Signature NAMI program.   This program was developed in Wisconsin and data only needs to be reported to NAMI Wisconsin.

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* 3. I understand that NAMI Wisconsin will cover some of the costs related to the training, including meals and training materials. Our affiliate or sponsored participants will be responsible for travel to and from the training, lodging and Friday and Sunday evening meals.  I also understand, a block of hotels rooms will be reserved by NAMI Wisconsin but the affiliate or trainee will have to call to place their name within the block to get the state rates we have held a month prior to the training. 

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* 4. I understand that any offering of NAMI Wisconsin Peer Support Group course is solely the financial responsibility of our affiliate.

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* 5. I agree that it is the responsibility of our affiliate to assist the teachers in finding a place to teach the course, arrange for publicity and cover incidental costs. 

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* 6. I certify that all trainees I am sending from my affiliate are persons who identify as consumers.  I also certify that I believe each of the trainees from this affiliate is far enough along in his/her recovery to participate in this training and to be a NAMI Wisconsin Peer Support Group Facilitator.

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* 7. I am aware all NAMI Support groups require TWO leaders/facilitators to follow validity and best practices established by NAMI and NAMI Wisconsin.  

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* 8. I believe that all the trainees I am sending from my affiliate have the skills to lead a support group including, verbal skills, reading skills, personal interaction skills.  

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* 9. SIGNED: please enter your name as signature.  Thank you!

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* 10. EMAIL ADDRESS:

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* 11. Please provide a list below of members attending this training that have your affiliates approval. 

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