PETRA Direct: CRSW Bootcamp Series Scholarship Application Question Title * 1. Please, enter your name Question Title * 2. Please, tell us what town you are located in. Question Title * 3. Do you currently work in recovery support? Yes No Question Title * 4. Please, tell us how you plan to use the education provided to you in the CRSW Bootcamp Series. Question Title * 5. Do you plan to provide recovery support services in Coos and/or northern Grafton counties? Yes No Question Title * 6. Do you plan to apply to become a Certified Recovery Support Worker (CRSW)? Yes No Question Title * 7. By applying for this scholarship, I understand that if accepted, I must complete the courses that I am registered for. Yes No Question Title * 8. Please, provide your contact information so that we may contact you regarding this scholarship. Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number Done