Peer Support 101 Application Applicant Information * 1. What is your name? (first and last name) OK * 2. What is your email address? OK * 3. What is your phone number? OK * 4. What is your address? (please include all info. including apt #, city and zip code) OK * 5. Please tell us which training location you are applying for (location and dates) OK * 6. Do you identify as being in recovery from a Behavioral Health diagnosis (mental health, substance use, alcohol use)? Yes No OK NEXT