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PEER SUPPORT TRAINING REGISTRATION/APPLICATION

Next Training Session

APPLICATION DUE: Friday October 12, 2018

COST: $350

DATES AND TIMES:

Thursday October 25, 2018 @ 8:30am – 4:30pm

Friday October 26, 2018 @ 8:30am – 4:30pm

LOCATION: Station 1, 16050 S. Cedar Road Lockport IL 60491

Name*
First Last
Hometown
Department(s)
Cell Phone*
Personal Email*
Please Choose One
- Upon successful completion of the training, I would like to be a Peer Supporter, meaning I am able and willing to meet one on one to provide peer support services to fire fighters.
- Upon successful completion of the training, I would like to remain active in the Peer Support program but prefer to remain a Peer Support Advocate. (This would mean that you would be a member of the Peer Support team but prefer to work as an Advocate for the team and not meet one on one with peers. Responsibilities would include but not be limited to, outreach, promoting and attending formal events like Road To Help and Re;act, writing articles for our newsletter)
Essay (Required)*
In the space below, please describe why you are interested in taking the Illinois Fire Fighter Peer Support training. Your essay will be reviewed by the ILFFPS Team: This is a personal question that requires a personal answer. There is no right or wrong answer –we are simply trying to understand who is applying to take the training, and for what reasons. We also would like to know if you have any personal or professional experience(s) that you believe would help you be an outstanding fire fighter peer supporter. These experiences are likely to be discussed during the training.
How Would You Like To Pay?*
- Pay Now with PayPal
- Bring Payment to Class
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"Illinois Firefighter Peer Support seeks to contribute and provide ongoing emotional wellness resources that are readily needed in the fire service and for emergency responders." Learn More...

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