Liars and Posers Application for Community Prevention Partner
Parties interested in becoming Licensed and Certified to deliver Liars and Posers should complete this form.
This application is used when appliying to become a consultant, agency or educational facilitator. Requirements to become licensed and certified apply. Applications are approved at the sole discretion of Freedom Youth Project Foundation (herein referred to as FYP)
Contact Information
Individual / Organization Name *
Your answer
Primary Contact *
Your answer
Contact Title *
Your answer
Mailing Address *
Your answer
Email *
Your answer
Phone *
Your answer
Number of Certified Trainers *
Your answer
Primary Contact
If application is for agency, name of person submitting application
Your answer
Email
Your answer
Phone
Your answer
Please choose the area for which you are applying: *
Acknowledgement
By signing below I acknowledge that, to the best of my knowledge, all information provided in this application is accurate and complete. I understand that FYP will review the information provided in this application and notify the individual / organization named on the application if distinction as FYP Community Prevention Partner is awarded. FYP reserves the right to request information needed to verify the accuracy of the information provided and may periodically audit an individual / organization for compliance with the guidelines associated with the FYP Community Prevention Partner at any time upon reasonable notice. If awarded, the FYP Community Prevention Partner distinction remains in effect for a period of 12 months unless otherwise terminated. Annual application is required to maintain the distinction. Nothing in this application, FYP Community Prevention Partner, or in the use of the emblem itself, shall confer any endorsement or approval of the Organization’s services by FYP. The program and associated emblem is intended only to convey that the individual / organization has met training standards.
Signature *
Please type full legal name
Your answer
Date *
MM
/
DD
/
YYYY
Submit
Never submit passwords through Google Forms.
This form was created inside of Freedom Youth Project Foundation. Report Abuse - Terms of Service