Jordan Peer Recovery

Registered Apprenticeship Program — New Apprentice Enrollment

1
Agreement Form
2
Intake Form
3
Aptitude Test
1

Apprenticeship Agreement Form

Download, complete, sign, and upload the form below.

Download Apprenticeship Agreement (PDF)
  • 1
    Complete all required fields:
    Name Residential Address Employer's Name Date of Birth Social Security Number Sex Veteran Status Education Level Completed Race
    Set School-To-Apprenticeship to No.
  • 2 Sign using a handwritten or digital signature. Typed signatures are not accepted and the form will be returned.
  • 3 Upload your signed form below. Your file will be saved automatically to Google Drive.
Upload Signed Form *

Click to select your file

PDF, Word, or image — max 10 MB
Uploading to Google Drive…

Your form has been submitted and saved to Jordan Peer Recovery's secure Google Drive.

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Step 1 of 3
2

Registered Apprenticeship Program Intake Form

Complete and submit the form below. Wait for the confirmation screen before continuing.

Step 2 of 3
3

Apprenticeship Aptitude Test

Select your track and complete the test below.

🤐

Peer Recovery Specialist

Select if you are enrolling as a Peer Recovery Specialist

🩹

Community Health Worker

Select if you are enrolling as a Community Health Worker

Step 3 of 3 — Final step

Congratulations!

You have successfully completed all enrollment steps.

1

A notification has been sent to your program coordinator at Jordan Peer Recovery. No further action is needed from you.

2

Your coordinator will review your submission and forward your Apprenticeship Agreement Form to the Department of Labor.

3

Within 48 hours, expect an email from your coordinator with access to your first course in Thinkific (Learning Management System).

A confirmation receipt has been sent to your email address. Please check your inbox (and spam folder if needed).