Programs If you would like to sign up for a new course, please select the program below: NameProgram*Skill Building Course to Address Teen Substance UseVirtual Parent Coach TrainingTraining Group*Columbus, OHCoaching Training Agreement Partnership to End Addiction Peer Parent Coaching Volunteer Agreement: You (the Volunteer) and Partnership to End Addiction, (the Partnership), agree that in exchange for training and the opportunity to volunteer as a Parent Coach, the following terms and conditions shall apply: The assignment begins during this virtual training and is expected to continue for a minimum of six months following the virtual training, or until the Volunteer and the Partnership mutually agrees on the discontinuation of the Volunteer’s service. During the Volunteer's first six months as a peer Parent Coach, the Volunteer must commit to coaching families for the Partnership. At the completion of the training, coaches should also have some comfort with technology and own a desktop computer, laptop or tablet, which can be used for coaching. During the Volunteer's first six months as a Peer Parent Coach, the Volunteer must commit to attending weekly Training and Support calls offered by Partnership and CMC: Foundation for Change (CMC: FFC) The Volunteer will perform peer-to-peer coaching services under the direction and control of Partnership staff, CMC: FFC supervisory staff directed by Jeff Foote, The Volunteer will perform services as directed in the training workshop. The Volunteer’s coaching services for callers will be of limited duration and scope, and will be specified as not being “therapy” or “treatment.” Volunteers will use their own judgment and discretion during coaching contacts with their clients and will be sensitive to protecting the privacy of information discussed. The Volunteer agrees to follow the directions of the staff and to abide by Partnership policies and procedures while carrying out these volunteer duties. The Volunteer acknowledges abiding by the Partnership’s Code of Conduct policy while signing this Agreement. The Volunteer is not an employee of the Partnership and is not entitled to receive salary, benefits or other The Volunteer understands that he/she/they does not qualify for workers’ compensation benefits and is expected to carry personal medical insurance to cover medical expenses for any injuries he/she/they incurs while performing volunteer services. The parties agree that this is the entire agreement, and no agreement, oral or written, exists outside of this Either party may terminate this agreement at any time for any reason upon immediate notice, oral or written, to the other RELEASE: By marking yes below, Volunteer confirms that agreement has been carefully read and all contents are fully understood. Volunteer releases the Partnership and its officers, employees, and representatives from any responsibility or liability. IN WITNESS THEREOF, the parties have executed this Agreement and Release as of the date below. MARKING yes below has the same effect as a signature.Do you agree to the statement above?*YesNoPlease enter today's date* Date Format: MM slash DD slash YYYY Address* Address Line 1 Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Cell Phone*Do not include country code i.e. US +1(718).Parent Coach Profile Please answer the following questions honestly and thoroughly. This information will be shared with the training staff in order to learn more about each of you, as participants and future Parent Coaches. At the end of the initial training weekend, some of this information will be shared among your group of trained Parent Coaches so you can all stay in touch. This information will not be used otherwise without your consent.How would you describe where you/your family are on your journey at the present?*My child/loved one is in long term recoveryMy child/loved one is in short term recoveryMy child/loved one has passed awayMy child/loved one is struggling with substance usePlease select the answer you feel most comfortable with. For example, recovery can mean different things to different families and we know no family's journey and situation is the same. If you want to explain your answer further, you can absolutely do so as part of your answer to the question below on how substance use has impacted your family.What is/was the primary substance your loved one's struggled/is struggling with?* Select All Marijuana Alcohol Heroin Cocaine or crack Prescription painkillers (Vicodin, Oxycontin, Percocet, etc.) Methamphetamine Benzodiazepines (Klonopin, Xanax, Valium, etc.) Prescription stimulants (Ativan, Ritalin) Nicotine (smoking/vaping) If polysubstance use, please check all that apply.How has substance use or addiction has impacted your family? (250-500 words please):*Why are you interested in becoming a volunteer Parent Coach and what do you hope to accomplish as a Parent Coach?*Do you have any experience working with families with loved ones with substance use disorders? If so, please summarize your experience:*Please note: The peer Parent Coach training will be held online, via Zoom. We will have a 90-minute introduction session followed by six sessions that occur once a week. Four of these sessions will be 90 minutes and two will be two hours. Participants are expected to: Attend all meetings live if possible. If you need to miss a meeting, please contact the training instructors. Complete homework assignments by the deadlines set by the instructors. We anticipate that homework should take, at most, 60-90 minutes per week. You will not be judged on spelling or grammar: the intent is to help you better understand the ideas we will use to help the parents/caregivers you will coach. Participate in a two practice coaching calls – one after session 4 and one after session 6. You will receive more specific details/logistics information after completing this registration form. Within a few days after completing this registration form, you will be contacted by a representative from the Partnership to schedule an appointment to discuss this training and expectations of a peer Parent Coach. You will also be able to ask any questions you may have. Please respond and keep that appointment, as it is very important to understand what to expect from the coaching program. Completion of this call prior to training is mandatory.* I understand and agree to Terms and Conditions*CAPTCHA* Required FieldsNameThis field is for validation purposes and should be left unchanged.