Please complete and submit for considerations.

* Legal First and Last Name
* Address
* Phone Number: ex. (area code) *** - ****
* Email Address
* Date of Birth: ex. 02/25/1991
* Are you currently unemployed?
* Were you terminated from your last position?
* Do you have a GED or High School Diploma?
* Attended and graduated a Certified Peer Recovery Specialist training with Anchor or PSN?
* Are you in recovery from mental health or substance use challenges?
* Are you a Family member of individual in recovery from mental health and/or substance use challenges?
* Did you leave your job due to mental health or substance use?
* Did you leave job due to re-locating/ or displaced due to domestic violence ?

Thank you for filling out this short pre-application. We will be in touch with you to complete initial screening. If found eligible we will schedule an initial zoom interview.