PEP Training Registration April 2026 Thank you for planning to attend our FPA 4-day Virtual PEP Training. Please take a moment to fill out the pre-registration form below. Question Title * 1. Work Contact Information Name * Agency Name * Work Address * Address 2 City/Town * State/Province * ZIP/Postal Code * Work Email * Work Phone * Question Title * 2. Are you available to attend the mandatory 1-hour Orientation on Monday, April 20 @ 9:30 AM – 10:30 AM? Yes No Question Title * 3. Are you available to attend all 4 days of training on Thu. 4/23, Fri. 4/24, Mon. 4/27, and Tue. 4/28 @ 9:30am - 3:00pm? Yes No Question Title * 4. Trainees are also required to participate in weekly, one-hour coachingcalls following completion of the virtual trainings. We will meet on Tuesdays & Thursdays @ 9:00am-10:00am from 5/12/26 through 7/9/26, skipping 6/4 and 6/9. I am available for all coaching call dates. I am not available for one or more coaching call dates. (List dates below) Please list these dates in the comment box below. Question Title * 5. Do you hold a valid FPA Provisional (temporary) Credential? Yes No Question Title * 6. Did you complete FPA Level 2 online PEP training modules hosted on the CTAC Self-Learning Center? There are 6 self-paced modules in total and a Certificate of Completion is available under your Transcript. Yes No Question Title * 7. Are you currently employed in a NYSOMH licensed, designated or funded program providing Medicaid reimbursable services of family peer support? Yes No Question Title * 8. Are you currently providing Family Peer Support Services that fall within the role of an FPA (employment or volunteer) and are working independently with parents/caregivers for at least 3 months? Yes No Question Title * 9. Does your supervisor approve of your registration request and availability for this training? Yes No Question Title * 10. Supervisor Full Name: Question Title * 11. Supervisor Email: Question Title * 12. If you have any questions or comments, please list them here in the comment box below or email us at FPACredential@FTNYS.org Done