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"The different programs offered has been very effective in informing us of all the aspects involved in the recovery process. The teaching styles are excellent." - Cindy Brewer

NAAW

Apply Online Step 1 of 2

Important information, please read before proceeding.

Note: Section A - Personal Information and Section C - Sponsor & employment information (must be printed & faxed to acquire sponsor signature) must be completed.

Section B - Personal History for CAT Series Applicants must be completed if applying for the CAT Series.

Section A - Personal Information:


*First Name

*Last Name

Middle Name

Have you taken training under another name? If yes, please provide.

*Address

*Reserve, Town/City, Province

*Postal Code

*Telephone

Fax

Email Address

Gender

Aboriginal Heritage

Band Name

Band Number (10 digits)

Last Grade or Degree completed
 
Have you been treated with any of the following
Alcoholism
Epilepsy
Mental Illness
Diabetes
Heart Disease
Other
If Other, please specify

Length of Sobriety

Are you on any medications? If so, please list
Doctor Name
Doctor Phone #
   
*Course(s) Applied For:
Community Addictions Training
Advanced Councellor Training
Program Management
Training of Trainers
Aboriginal Addictions Services Contract
Aboriginal Addictions Services Diploma
Community Wellness Certificate

Are you applying for our Summer Session?
Yes No

Have you previously taken any courses offered by Nechi Institute?
Yes No

   

Section B - Personal History for CAT Series Applicants:
   
Please describe your history with addictions:
 
Do you have any experience in the field of Human Services or Management? If so, please provide details:
 
Describe your employment situation and how you think Nechi training will assist you personally or professionally:
 
Have you taken any Adult Education Courses? If yes, please provide details:
 
When you have finished please click the SEND button to submit your form.   

 

 
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