Application to Become a Trainer on Supported Decision-Making and Other Legal Support Options in Arizona

Applicant Information

First Name *

Last Name *

Phone *

Email *

Address

Street Address

City

State

Country

Postal code

Background and Role

If Other, please explain below.

Please describe your experience in helping others make decisions for themselves. *

Please share your experience or understanding of Supported Decision-Making (SDM) and/or alternatives to guardianship. *

Do you have any professional conflicts of interests that should be reported? *

If a conflict exists, please explain.

Training Purpose and Goals

Why do you want to become a certified trainer on SDM and legal support options? *

In what settings do you plan to deliver this training? (Check all that apply) *

Who do you plan to reach with your training? Please describe your target audience and how you plan to connect with them. *

Are you able to commit to delivering this training in a way that centers around the voice and rights of people with disabilities? *

If No or Unsure, please explain

Skills and Logistics

Please explain your prior experience leadings trainings or workshops. *

Are you comfortable using visual materials (PowerPoint, handouts, etc.) and facilitating group discussions? *

By checking each check box you verify that you are able to commit to: *

Attending a full “train-the-trainer” session, approximately 4-5 hours

Using approved training materials only

Tracking your trainings (audience, location, # reached)

Participating in periodic check-ins or updates

Conduct at least four trainings per year to maintain your certificate of completion

Do you have any group or professional affiliations that may help disseminate information about the trainings? *

If Yes, please list the potential groups and/or professional affiliations.

Accessibility and Accommodations

Do you need any accommodations to fully participate in the training or to deliver the training in your community? *

If Yes, please explain below

Final Questions

How did you hear about this opportunity? *

Is there anything else you'd like us to know as we review your application? *

By checking this box, I consent to receive messages related to my application. These messages may include appointment reminders, and notifications among others. Message frequency may vary. Message & Data rates may apply. Reply HELP for help or STOP to opt-out.

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