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NATIONAL PEER HELPERS ASSOCIATION

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					                                TRAINING/CONSULTING
                                QUESTIONNAIRE


Directions:
Thank you for considering NAPP as a potential resource as you work to advance
the cooperative culture of your school, agency or community. Our goal is to
provide communities and organizations with the highest quality training related to
the peer helping skills, trainer skills, as well as program development,
implementation, management, and customized models. The following information
is requested to ensure a match of the most appropriate training to meet your
needs and expectations. Please complete all the items on this form, sign and
submit by mail or FAX to:

National Association of Peer Programs Questions?
PO Box 10627                          Email: napp@peerprograms.org
Gladstone, MO 64188-0627              or phone: 877-314-7337
Toll-free fax: 866-314-7337

                                                 _______________
                                                 Date
   ______________________________________________________________
   Name                                    Title

   ______________________________________________________________
   Name of your peer program (if applicable)

   ______________________________________________________________
   Name of organization (if applicable)

   ______________________________________________________________
   Address

   ______________________________________________________________
   City                          State     Zip

   ______________________________________________________________
   email                         Phone

   ______________________________________________________________
   Fax



NAPP Training/Consulting Questionnaire                                 Page 1 of 5
      1. How did you learn of the training we provide?
         NAPP Conference
         NAPP Training Institute
         NAPP Listserv/Bulletin Board
         E-mail
         NAPP Website
         Colleague
         NAPP Representative
         Word-of-Mouth
         Past presentation or training
         NAPP Perspectives in Peer Programs or Newsletter
         NAPP Certified Trainer/Consultant

      2. What type of program(s) operates in your agency?

          Peer Listening/Counseling
          Peer Tutoring
          Peer Education
          Conflict Mediation
          Transitional Program
          Community Based
          Peer Ministry
          Group-Led Programs
          Service Learning
          Other(s) (Please Describe)

          ________________________________________________________

          ________________________________________________________

          Check here if you are just getting started and do not know what
          will be offered. _____

      3. Please list previous training which has been delivered to peer
         helpers and/or peer professionals in your agency.

          Peer Helpers:

          Type of Training               Training Source

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________




NAPP Training/Consulting Questionnaire                            Page 2 of 5
          Peer Helping Professionals:

          Type of Training               Training Source

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      4. What objectives do you want to accomplish through this event?
         (What do you want participants to learn and be able to do after
         attending?)

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      5. Event Details: Do you have a specific training event theme in
         mind? If so, indicate of the following selections you want:

          Cultural Diversity
          Bullying/Harassment
          Stress Management
          Conflict Resolution
          Self Care/Wellness
          Cultural Differences/Bias Behavior
          Teen Sexuality
          Substance Abuse
          Media Awareness
          Resiliency
          Violence Prevention
          Crisis Awareness/Response
          Students with Disabilities
          Other(s) (Please Describe)
          ________________________________________________________

          ________________________________________________________

          ________________________________________________________




NAPP Training/Consulting Questionnaire                           Page 3 of 5
      6. List any of the following skill specialty areas you would like to
         develop in your peer helping professional staff.

          Evaluation
          Group Facilitation
          Program Consulting
          Counseling
          Crisis Management
          Curriculum Development
          Program Development
          Supervision
          Organizational Consulting
          Other(s) (Please Describe)

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      7. What experience does your community have with NAPP’s
         Programmatic Standards and Ethics?

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      8. What is the anticipated number of participants? _______________

      9. What types of individuals do you anticipate being in the
         participant population for this event? (youth, peer educators, peer
         trainers, peer program administrators. parents, health care, social
         services, seniors, etc.)
         ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      10. Will the participants be multi-generational?

          ___Yes
          ___No



NAPP Training/Consulting Questionnaire                              Page 4 of 5
      11. What percentage of the participants will have previous Peer Helping
          experience?

          ________________________________________________________

      12. Do any of your participants have special needs? (language, unique
          previous experience with Peer Helping, such as curriculum
          designers, writers, program developers, etc.)
          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

      13. Please provide any other important information: (i.e., timeframe
          for training; budget for training)

          ________________________________________________________

          ________________________________________________________

          ________________________________________________________

   Thank you. Please submit to the address on page one. A member of the
   NAPP Professional Development Committee will contact you to discuss
   in more detail your training/consulting needs and how NAPP may help.




NAPP Training/Consulting Questionnaire                             Page 5 of 5

				
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