Instructor
Martha Thompson
Class Dates
-
Location
746 Cumberland St Lebanon PA 17042
Sponsoring Organization
Empower the Mind
Class Type
Private
PCB Account Status
Login
Account Information
Password
Contact Information
Name
Gender
Home Address
Ethinicity
Questions
I have access to reliable high-speed internet and a working laptop or computer
I am comfortable with computers, computer applications and other technology
Do you have a High School Diploma/GED or higher?
Do you have a personal, lived substance use history and recovery experience?
Are you a family member of someone with a substance use disorder?
Do you currently have a minimum of 18 months, in a continuous manner, of recovery experience?
Do you regularly and actively participate in a program of recovery?
Are you able to attend the entirety of the in-person requirement (66 hours)?
Are you able to complete all of the online homework (12 hours)?

RELEASE

I request that the Pennsylvania Certification Board (PCB) grant the credential to me based on the following assurances and documentation:

  • I subscribe to and commit myself to professional conduct in keeping with the PCB Code of Ethical Conduct.
  • I certify that the information given herein is true and complete to the best of my knowledge and belief. I also authorize any necessary investigation and the release of information relative to my application.
  • Falsification of any information will nullify this application.
  • I consent to the release of information contained in my application and any other pertinent data submitted to or collected by PCB to officers, members, and staff of the aforementioned Board;
Statements