Empower SCI Montana: Peer Mentor Application
Application as a Peer Mentor for the one-week residential program at the University of Montana at Missoula
Please complete and submit this form by February 28.
Notification of acceptance: May 1.
MT Staff Training: May 30 and 31, 2020
MT Program Dates: May 31 to June 6, 2020
Note: if you require >3 hours of personal care assistance, please arrange caregivers to provide your personal care assistant care. Empower SCI will pay for the room and board for both peer mentor and one personal care assistant.
Consider listing your "personal" email address here instead of a school or business account. Because of our volume of applicants, responses to school and business based emails are occasionally flagged as spam in our responses.
Please include an area code
What is your T-Shirt Size?
What age will you be at the start of the program?
Please enter the whole number age (years) you will have attained by program start date: Montana 05/31/2020, or New York 07/12/2020. Example: "20".
Are you also interested in applying to volunteer at the New York program?
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This form was created inside of Empower Spinal Cord Injury.