Name *

First Name

Last Name

Phone

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Would you like to request the link to download the Apostles of Life Program Overview Evaluation and Implementation Manual? *

Yes

No

Confirm Adherence to Copyright and Liability for Use *

Check the appropriate response below to affirm that by accepting receipt of the copyrighted Program Overview Evaluation and Implementation Manual, that the manual will not be shared with others except for the purposes of registered Apostles of Life program implementation, and that the user as a Qualified Peer Coordinator (QPC) or Peer Support Specialist (PSS) assumes all risks and liabilities associated with program implementation.

Yes, I agree to abide by the copyright of the Program Overview Evaluation and Implementation Manual and to assume all risks and liabilities associated with program implementation/participation as a Qualified Peer Coordinator (QPC) or Peer Support Specialist (PSS).

No, I do not agree.

Self-Attestation *

Check the appropriate response below to self-attest to having lived experience with a mental health condition for which you are currently in recovery, and that you identify as a Christian servant leader in your community.

Option 1 "Yes, I attest that I am a Christian servant leader in recovery and have lived experience with a mental health condition."

Option 2 "I do not attest that I am in recovery for a mental health condition."

Option 3 "I do not attest that I am a Christian servant leader in my community, but I am in recovery for a mental health condition."

Option 4 "I am a Christian servant leader in my community, but I do not have lived experience with a mental health condition."