PeerForce Pre-Approval Application

Applicant Information
Name:*
First M.I. Last
Address:*
Street Address Address Line 2 City State ZIP Code
Preferred Email Address:*
All communication regarding pre-approval will be sent to this address.
Phone:*
Do you currently have any other certification through Texas Certification Board (TCB)?*
- Yes
- No
What supplemental training will you be applying to?*
- Mental Health Peer Specialist (MHPS)
- ReEntry Peer Specialist (RPS)
Completing the Core training and passing the assessment is required before applying for pre-approval. Please list your training completion date:*

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Employment Information
Are you currently working or volunteering in Peer Support?*
- Yes
- No
If yes, what is the name of your organization? (enter N/A if you are currently not working or volunteering)*
Address:
Street Address Address Line 2 City State ZIP Code
Eligibility Checklist*
- I am 18 years or older
- I have a high school diploma or GED
- I myself completed this application
- I identify myself as a person who has personal lived experience with mental health recovery (MHPS) or incarceration (RPS)
Name
This field is for validation purposes and should be left unchanged.

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