Warm Line Counselor Application

1) What interests you in becoming a Warm Line Counselor?

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2) Do you have any specialized training, talents, skills, or strengths? Please describe.

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3) Have you completed training in a mental health peer certificate program? Please check one.

[ ] RAMS Peer Specialist Mental Health Certificate Program

[ ] BestNow

[ ] Community Action Marin

[ ] Other: ____________________________________________________________________________________________

4) Do you have lived experience of mental health challenges that would enable you to act as a “peer” to others with similar challenges? If you would like to share, please describe.

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5) To what extent do you feel comfortable sharing your lived experience with others?

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6) Do you have familiarity with peer support and the mental health recovery model? Please describe.

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7) Do you have experience in providing peer support or counseling to others? Please describe.

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8) Apart from English, do you speak any other languages? If so, please state which ones.

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Currently, our hours are Monday-Friday 7am-11pm and Saturday-Sunday 11am-7pm. However, we anticipate expanding our hours to a 24/7 model by July 2015. Knowing that, please state when you would be able to work:

Times/Days 7-11am 11am-3pm 3-7pm 7-11pm 11pm-7am (Overnight)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Thank you for your interest in the Warm Line Counselor position!