Cornbelt FPD, IL Registration

PEER SUPPORT TRAINING

REGISTRATION/APPLICATION

APPLICATION DUE:

Friday, November 26th, 2021

COST: The cost of this training is covered by the Illinois State Fire Marshal

DATES AND TIMES:

Saturday, December 4th, 8:30am – 4:00pm
Sunday, December 5th, 8:30am – 4:00pm

LOCATION:

Cornbelt Fire Protection District

506 E. Main Street

Mahomet, IL 61853

Register Using the Form Below

Name*
First Last
Cell Phone*
Personal Email*
Training Location*
Hometown
Department(s)
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.
Select Payment Option*
- Covered by Grant from the State Fire Marshall
Once you have submitted your registration, please email ilffps1@gmail.com to receive your custom invoice
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Our Vision

"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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