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PEP Training Registration June 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.
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1.
Work Contact Information
(Required.)
Name
*
Agency Name
*
Work Address
*
Address 2
City/Town
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State/Province
*
ZIP/Postal Code
*
Work Email
*
Work Phone
*
*
2.
Are you available to attend the mandatory 1-hour Orientation on Monday, June 1 @ 9:30 AM – 10:30 AM?
(Required.)
Yes
No
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3.
Are you available to attend all 4 days of training on Thu. 6/4, Fri. 6/5, Mon. 6/8, and Tue. 6/9 @ 9:30am - 3:00pm?
(Required.)
Yes
No
*
4.
Trainees are also required to participate in weekly, one-hour coaching
calls following completion of the virtual trainings. We will meet on Mondays & Wednesdays @ 9:00am-10:00am from 6/22/26 through 8/12/26.
(Required.)
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.
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5.
Do you hold a valid FPA Provisional (temporary) Credential?
(Required.)
Yes
No
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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.
(Required.)
Yes
No
*
7.
Are you currently employed in a NYSOMH licensed, designated or funded program providing Medicaid reimbursable services of family peer support?
(Required.)
Yes
No
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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?
(Required.)
Yes
No
*
9.
Does your supervisor approve of your registration request and availability for this training?
(Required.)
Yes
No
10.
Supervisor Full Name:
11.
Supervisor Email:
12.
If you have any questions or comments, please list them here in the comment box below or email us at FPACredential@FTNYS.org