Take Your Heart to Work® - NC Certified Peer Support Specialist Training Application
Please complete the information below to register for the Take Your Heart to Work® NC Certified Peer Support Specialist training course.  

COURSE INFORMATION:

The name, "Take Your Heart to Work," is a Meryl Streep quote that she once used in a college graduation keynote speech.  The entire quote is the essence of this curriculum: "Integrate what you believe into every single area of your life.  Take your heart to work, and ask the most and best of everybody else, too.  Don't let that get beaten down."  This training focuses on developing a NC Certified Peer Support Specialist (NC CPSS) who is well equipped and comfortable with working with other professionals on a treatment team or any Mental Health / Substance Use Disorder agency.  The NC CPSS will serve as an equal partner with unique qualities of lived experience.  The trainers' goals are to provide opportunities, in a caring environment, for the participants to be knowledgeable and marketable in the Peer Support Workforce.  

This training includes sessions on self-monitoring wellness, building relationships, connecting to others, bridging the service gaps, the NC CPSS Code of Ethics, interdependence in the community, effective communication, decision-making tools, crisis as an opportunity to change, Substance Use Disorders, and supporting Service Members and their families.

NOTE:  A certified 16-20 hour wellness plan training course is a prerequisite (taken before) the Take Your Heart to Work® Peer Support Specialist Training course.  We recommend the Whole Health Action Management (WHAM) training.  More information can be found here:  http://bit.ly/signup4wham.


FEES & PAYMENT INFORMATION:

Take Your Heart to Work®  Fee: $375.00  
Whole Health Action Management (WHAM) Fee:  $125

*Checks, Cash, Credit Cards, CashApp, and Venmo are accepted forms of payment.  Contact Melissa Lewis for online payment instructions.  

*A $100 nonrefundable deposit is required for each class.  Your deposit will be applied to the class fee.  The deposit is due one week before the first day of class.  The remainder of the class fee is due on the first day of class. 

*There is an additional 5% fee for online & Credit Card payments.  

*Scholarships may be available if you qualify through NC Vocational Rehabilitation, VA (Veterans Affairs) Vocational Rehabilitation & Education (VR&E), and/or NC Works.  

*Payments must be made in full at least 1 week before the first day of class.


ADDITIONAL INFORMATION:  

*The registration deadline is 2 weeks before the first day of class.  There is an assignment that is also due 2 weeks before class starts, so be sure to register early in order to have time to effectively complete the advanced assignment.  

*There does need to be a minimum number of participants in the class, and if we do not meet that number (per state requirements), we will have to cancel the class.  If the class has to be cancelled for this (or any other reason – like bad weather), you will be notified by email as soon as the decision is made. 

*Where it is not a requirement for graduation from the Take Your Heart to Work - Peer Support Specialist Certification Training course, it IS a requirement of the NC Certified Peer Support Specialist Program, that an individual seeking to become a Certified Peer Support Specialist (CPSS) have at least one year of living in recovery from a mental health and/or substance use disorder.

Contact Melissa Lewis at melissa.lewis@creeksiderts.org or 252-349-0220 if you have any questions or need more information.


Upcoming Take Your Heart to Work® courses include:  

**Saturday -- Sunday (May 4-5, 11-12, & 18-19, 2024, from 8:00 a.m. - 5:00 p.m.) at Peace Counseling Center (1917 Trent Blvd, New Bern, NC  28560) 
**This class is FULL**

**Saturday -- Sunday (August 10-11, 17-18, & 24-25, 2024, from 8:00 a.m. - 5:00 p.m.) at Peace Counseling Center (1917 Trent Blvd, New Bern, NC  28560)
**Location May Change** You will be notified via email if location changes.
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Participant Name *
Please list first & last name
Email *
Please list your email
Phone *
Please list your phone number
Mailing Address *
Please list your complete mailing address (including City, State, & Zip Code)
Emergency Contact *
Please list the Name of your Emergency Contact
Emergency Contact - Relationship *
Please list the Relationship you have with your Emergency Contact (Friend, Parent, Child, etc.)
Emergency Contact - Phone Number *
Please list the Phone Number of your Emergency Contact
Are you in recovery from a mental health diagnosis or substance use disorder (substance abuse)? *
If you answered "Yes" to the previous question, What is your recovery date?  If you answered "No," please type "None." *
Do you identify yourself as a person who has received or is receiving services for mental health and/or a substance use disorder (substance abuse)?  *Note: Having received professional services is not a requirement. *
*Please Note: Where it is not a requirement for graduation from the Take Your Heart to Work - Peer Support Specialist Certification Training course, it IS a requirement of the NC Certified Peer Support Specialist Program, that an individual seeking to become a Certified Peer Support Specialist (CPSS) have at least one year living in recovery from a mental health and/or substance use disorder. 
Please explain your answer to the previous question. *
Are you willing to openly share your lived experience with others? *
Describe what has been helpful in your recovery.  What tools do you use in your daily life? *
Are you employed? *
If you answered "Yes" to the previous question, Where do you work?  If you answered "No," please type "None." *
Are you a student? *
If you answered "Yes" to the previous question, What is the name of your school?  If you answered "No," please type "None." *
Are you Active Duty or a Veteran of the US Armed Forces? *
Are you registered with Vocational Rehabilitation?  If you are, please contact your counselor and ask about funding for this training. *
If you answered "Yes" to the previous question, Please list the name and contact information (phone number & email) for your Vocational Rehabilitation Counselor.  If you answered "No," please type "None." *
Who will be responsible for payment of this training course? *
Required
If someone other than you (the participant) will be responsible for the cost of this training course, please list the name and contact information (phone number & email) for that person or agency.  Payment for this course must be received at least one (1) week prior to the first day of the class. *
Have you completed the WHAM (Whole Health Action Management) or WRAP® (Wellness Recovery Action Plan®) class? *
Do you have and actively use a WHAM Plan or WRAP? *
List certified trainings you have graduated from in the past 2-3 years. *
What does recovery mean to you?  What factors are important in your own recovery? *
Peer Support Specialists are models of recovery for others.  In what ways do you demonstrate recovery and goals geared toward a full and meaningful life in your community? *
Share about how you use natural supports (unpaid supports such as friends, family, etc.) in your recovery. *
Would you be able to support someone whose idea or pathway of "recovery" is different than yours?  Please explain your answer. *
Describe (1) What strengths you have that would help you be a better Peer Support Specialist, and (2) What skills you feel you need to develop.   *
This training class is an intensive course built on interaction and sharing of behavioral health and/or substance use experiences as they lead to recovery.  (1) What will be your greatest challenge in attending and participating in the training class, and (2) How will you address that challenge? *
Please write 1-2 paragraphs about (1) Why you want to participate in this training, (2) Your expectations for this training, and (3) What "Take Your Heart to Work" means to you. *
When are you able to attend Take Your Heart to Work classes? *
Please choose which class you plan to attend.
Are you able to commit to actively participate in all sessions of the Take Your Heart to Work® training? *
Please list any accommodations you will need during the Take Your Heart to Work® course: *
For example:  Do you have a mobility device (therapeutic stroller, walker, wheelchair, etc.)?  If there are no accommodations needed, please answer "None."  Reasonable accommodations will be made for all people.
Please list any allergies you have: *
(For example:  Are you allergic to peanuts, dogs, etc.)?  If you do not have any allergies, please answer "None."
Prerequisites:  The following activities must be completed before you can participate in the Take Your Heart to Work® NC Certified Peer Support Specialist Training course, unless prior approval has been granted.  Do you agree to complete the required prerequisites before participating in the Take Your Heart to Work® course? *
1.  Graduation from on certified wellness plan training.  It must be a certified plan that you write for yourself to help you monitor your wellness.  The following are examples of accepted trainings: (a)  A recent 16-20 hour Whole Health Action Management (WHAM) training; More information can be found here:  http://bit.ly/signup4wham.  (b)  A recent 20 hour National Alliance for Mental Illness Peer-to-Peer training; or (c)  Copeland Center - Wellness Recovery Action Plan (WRAP) training, or (d) Other 16-20 hour certified wellness plan training.  Provide additional details and explanation of training for approval.  2.  A graduation certificate or proof of completion of one of the above training sessions is required on or before the first day of the Take Your Heart to Work® course.  3.  Completion of an online advanced assignment and submitted to Melissa Lewis (melissa.lewis@creeksidertw.org) at least one week prior to the first day of the Take Your Heart to Work® course.  Topics include taking care of yourself, and history of the Peer Movement.  —  You will receive an Acceptance Letter via email if you are approved to participate in the Take Your Heart to Work® training course.  You will also receive the Advanced Assignment at least 2-3 weeks before the training.  If you do not receive these documents, you will need to wait for the next training.  —  NOTE:  Accommodations will be made for those who do not have access to the internet.  4.  Payment in full submitted to Melissa Lewis (or Monroe Consulting, LLC) at least one week prior to the first day of class.  Notify Melissa Lewis at melissa.lewis@creeksidertw.org, if you are unable to attend a training.  There is usually a waiting list, and we would like to provide others the opportunity to attend.  
Please list your name as you would like it to appear on your certificate: *
I agree to allow Creekside Recreational Therapy Services to take photos and/or videos of myself to use for promotional and educational purposes. *
I would like more information about Creekside Recreational Therapy Services and upcoming classes and events.  Please add me to the mailing list. *
How did you find out about this class? *
Please choose any and all the ways you learned about this class.  If it was from a friend, family member, or someone else, please also choose "Other" & type their name in the space available.  Thank you.
Required
I have read this application and agree to the terms: *
Please type your first & last name to confirm the answer to the previous question.   *
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