Application: Peer Support Specialist Certificate

Contact Information
Name*
First Last
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Student Information
Are you a current UNR student?*
- Yes- Please continue the application form.
- No- Please apply to UNR at unr.edu/admissions
Student Type*
- UNR Undergraduate Student
- Non-Degree or Graduate Special
UNR Major*
Last Four Digits of your NSHE ID #*
CAS 154 Status?*
CAS 154 is prerequisite!
- I have completed CAS 154
- I am currently enrolled in CAS 154
Do you identify as a person in recovery from a substance use disorder or mental health issue?*
SAMHSA's working definition of recovery from mental health and/or substance use disorders is a process of change through which individuals improve their health and wellness, live a self-directed life, and strive to reach their full potential.
- Yes
- No
Final Application Information
Today's Date*
MM slash DD slash YYYY

Contact Information