TO: Floridians Interested in Certification as Recovery ...

TO:

FROM: RE:

Floridians Interested in Certification as Recovery Peer Specialists or Recovery Support Specialists The Florida Certification Board, Inc. Scholarship Program

The Florida Certification Board, through funding from the Florida Department of Children and Families, Office of Substance Abuse and Mental Health (Contract #LH290) announces

A SCHOLARSHIP PROGRAM for PERSONS SEEKING CERTIFICATION, REINSTATEMENT or RENEWAL as a CERTIFIED RECOVERY PEER SPECIALIST or a CERTIFIED RECOVERY SUPPORT SPECIALIST.

Scholarships are available now through June 30, 2019. To apply interested persons, must attest to financial need, by completing the FCB Scholarship Request Form for financial assistance with application, certification examination, reinstatement and/or renewal fees. All applicants will receive award notice within five (5) business days after receipt of the Request Form. Once approved for financial assistance, recipients must use the scholarship within (120) days or it will be voided and another Request Form must be submitted.

Certification Application Fee Scholarship. When submitting a scholarship request for certification application fees, applicants, must also complete the Certification Application online or in hard copy at .

Reinstatement Fee Scholarship. If requesting financial assistance to reinstate an inactive CRPS or CRSS certification, applicants must complete a Reinstatement Application. Inactive Status refers to certifications that have lapsed for less than three years.

Renewal Fee Scholarship. If certification has been inactive for over three years (Expired Status), a new, full certification application and examination is required.

Certification Status. To determine the status of a certification, individuals can go to the FCB website at and follow these steps:

? Click on the Verify Certified Professionals box to access FCB's online portal. ? Click on the word "Certification" ? Click on the word "Search" ? Type the individual's name into the search box

All forms required for the scholarship program can be downloaded from the FCB website at and submitted to admin_assist@ or by fax 850-222-6247

The Florida Certification Board, 1715 S. Gadsden Street, Tallahassee, FL 32301 850-222-6314 850-222-6247

SCHOLARSHIP REQUEST

CERTIFICATION FEE ASSISTANCE for

Certified Recovery Peer Specialists and Certified Recovery Support Specialists

Please complete the information below if you are in need of financial assistance to apply for, renew or reinstate a certification as a Certified Recovery Peer Specialist (CRPS) or a Certified Recovery Support Specialist (CRSS). Financial assistance can be requested to pay for application fees, certification exam fees, reinstatement fees and renewal fees. **By filling out this form you are attesting that you are in a financial hardship and need assistance with paying the required fee.

Award Criteria:

? Resident of Florida; U.S. citizen or otherwise authorized to work in the United States ? Financial need

I. Personal Information

Name:

Permanent Address:

City/State/Zip:

Phone:

Email:

_

II. Are you a U.S. citizen or otherwise authorized to work in the United States?

Yes

No

III. Credential Sought

Certified Recovery Peer Specialist Certified Recovery Support Specialist

IV. Have you ever been awarded a certification by the Florida Certification Board?

Yes

No

If yes, please indicate the credential and its number:

V. Are you currently employed? Yes No

VI. Are you required to self-pay to obtain this certification? Yes No

Funding for this scholarship program is provided by the Florida Department of Children and Families, Office of Substance Abuse and Mental Health through Contract #LH290 Page 1

VII. Please indicate the fee(s) for which you are requesting financial

assistance.

Application Fee ($100) Certification Exam Fee ($65) Reinstatement Fee ($150) Renewal Fee ($75)

VIII. Use of Scholarship Funds

I acknowledge that, if awarded scholarship funds, I will have 120 days (4 months) to use the scholarship or it will be voided.

Yes

No

IX. Attestation for Financial Assistance

To the best of my knowledge, I have provided the Florida Certification Board accurate information concerning all questions on this application. I verify that I am in need of financial assistance to apply for, renew or reinstate a certification as a Certified Recovery Peer Specialist (CRPS) or a Certified Recovery Support Specialist (CRSS). I understand that funds are limited and are intended for those who require financial assistance due to limited or no income, have no other means of financial support or do not receive reimbursement or payment from their employer for certification. **By signing this form you are attesting that you are currently in a financial hardship and need assistance with paying the required fee.

Signature of Applicant Date

__________

For FCB Office Use Only: Date received: Staff reviewed: Amount of financial assistance awarded:

Funding for this scholarship program is provided by the Florida Department of Children and Families, Office of Substance Abuse and Mental Health through Contract #LH290 Page 2

 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download