Peer Recovery Coach Scholarship

Name(Required)
Address(Required)
Gender (Mark only one oval)(Required)

Race

Are you receiving SNAP benefits?(Required)
Are you an FTDC Graduate or Participant?(Required)
Are or were you involved in Corrections?(Required)
Are you an PPWFC Intern in SRC’s Workforce Program?(Required)
Our classes have a policy of confidentiality. Names, specific conditions, and other personal details are held in the strictest confidence.(Required)
Please check yes, if you agree to adhere to this policy.
Applications are reviewed monthly, and funding is not guaranteed. Thank you.
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