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Application to List Peer Services, Program or Activity
To list your services on our peer pages:

To insure that you are not wasting your time completing the application, it may help to read the conditions associated with listing prior to starting the application.

APPLICATION FORM:

(NOTE: This application is submitted to a secure server. We also adhere to a strict privacy policy.)

I. Contact Information
Your full name (required)
Preferred title
The name of your organization or service (required)
Street (required)
City (required)
Province/State (required)
Postal/Zip Code (required)
E-mail address (required)
URL on WEB
Business phone (required)
Fax
Personal phone (required, but will not be included in listing)

2. Service Information
Describe your peer service goals, mission, vision, or purpose:

What do you call the people who provide the
peer services? (peer counsellors, peer assistants, etc.)

What are the primary services the peer assistants provide?

How do you select the peer assistants?

What kind of training do you provide for the peer assistants:
If you use a specific curriculum or manual, please include the name.

In what professional organization or peer association do you
currently hold membership(s)?

What is the URL for the page which will (does) contain the link to Peer Resources? When will this link be in place?

What would you like your listing to say:

3. Conditions for Listing

Return to the beginning of this application.

Yes, I have read and agree to the conditions as stated.
No, I do not agree to these conditions

Please make sure you have read the conditions listed in Section 3, and have checked the appropriate button at the end of that list before submitting your application.

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Before submitting your link, please type the above security code into the text box directly below it. Doing so will help reduce spam attempts. Thank you.




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