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Virtual Peer Support Network - Volunteer Interest Form

Thank you for you interest in becoming a peer supporter! Please tell us more about yourself and your experience by completing this form. Someone from the Betsy Lehman Center will be in touch with you.
1. Contact Information *This question is required.
This question requires a valid email address.
Workplace/system
Department/specialty
Role
2. Gender *This question is required.
3. Race/Ethnicity (Check all that apply)
4. Do you speak any languages other than English?
5. Volunteers are required to attend 4 hours of training (available as 1, 4-hour session or 2, 2-hour sessions) before becoming a peer supporter. Are you willing/able to attend the needed training sessions? *This question is required.
6. Are you interested in becoming a peer supporter with the Virtual Peer Support Network (VPSN)? *This question is required.
Please provide one professional reference
7. Professional Reference (If you are currently part of a peer support program at your organization, consider providing the contact information for the person who oversees the program) *This question is required.