Hire Supervise Retain PSPs

HIRE, SUPERVISE, & RETAIN YOUR PEER SUPPORT PROFESSIONALS
Name*

First NameLast Name
Please select the class you wish to attend:*

January 12, M, 9am to 5pm - ZOOMMarch 13, M, 9am to 5pm - ZOOMMay 8, M, 9am to 5pm - ZOOMJuly 13, TH, 9am to 5pm - ZOOMSeptember 15, F, 9am to 5pm - ZOOMNovember 13, M, 9am to 5pm - ZOOM
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Field Credentials*
(MHP, PSP, etc)
Current Agency*
What program do you oversee?*
How many Peer Support Professionals work under you currently?*
Signature*

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Date*

MonthDayYear
Date
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HIRE, SUPERVISE, & RETAIN YOUR PEER SUPPORT PROFESSIONALS