(207) 389-5105 info@peerrecoverycoachme.org

Maine Peer Recovery Coach Certification Board

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Maine – Registered Peer Recovery Coach Application

Registered Coach Application

Applicant Information

Address *
Address
House Number & Street
Address Line 2
City
State/Province
Zip/Postal
If we need to contact you regarding your application, please indicate your preference: *

Education/Training

Location/Date
Trainer
Location/Date
Trainer
Maximum upload size: 2MB

Attestation Statement

Recovery is a process of change through which people improve their health and wellness, live self-directed lives, and strive to reach their full potential.

I attest that I am an individual or affected other in recovery (see page 3 of the MRCCB Applicant Manual) and work each day to support my life in recovery within the following four dimensions:

Health *
Home *
Purpose *
Community *
Clear

This project has been made possible with funding provided by:

MRCCB c/o PRCC
102 Bishop Street
Portland, Maine 04103

Connect With Us

Phone: (207) 389-5105
Email: info@peerrecoverycoachme.org

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