New Jersey Prevention Network
Certified Prevention Specialist (CPS) & Associate Prevention Specialist (APS) Student Scholarship Application

Please note: The information you supply directly populates your profile in our database. NJPN will be unable to contact you if you provide incomplete or incorrect information. Please proofread carefully before submitting. Applications that do not meet this criteria will be delayed.

Contact Information

PERSONAL

* Required Field

If you do not live in NJ, pick the NJ county closest to your home.


WORK

* Required Field


All communication is done via e-mail, so either a home or work e-mail address is required.




Experience and Education

* Required Field

P101 – Prevention Program Planning and Assessment
P102 – Prevention Activities and Methods
P103 – Program Design
P104 – Evidence Based Prevention Models
P105 – Prevention Program Evaluation
P201 – Dynamics and Process of ATOD Dependency and Abuse
P202 – Impact of Substance Use Disorders on Families and Larger Systems
P203 – Prevention Issues with Special Populations
P204 – Prevention of Violent and Compulsive Behaviors
P205 – Presentation Skills
P301 – Public Relation Skills
P302 – Interpersonal Communication Skills
P401 – Community Assessment
P402 – Coalition Building and Maintenance
P403 – Coordinating Community Prevention Activities
P501 – Introduction to Methods and the Impact of Environmental Change
P502 – Assessment and Planning of Environmental Strategies
P503 – Implementation & Enforcement of Environmental Change
P601 – Professional Growth
P602 – Ethics and Legal Issues for Prevention Specialist
P603 – Cultural Competency
P604 – Self Care for the Prevention Specialist

Student Statement

* In your own words please tell us why you should be selected for the training and workforce Development Initiative Scholarship program. Include the reason(s) you desire a career in the addictions field.

Agreements

Summary Information

If you are CURRENTLY working at a DMHAS-licensed substance abuse treatment or mental health agency or a state psychiatric hospital, a Clinical Supervisor Confirmation Form must be completed for you before your application can be reviewed. This form will be available to download once you click the SUBMIT button below. Please complete it with your supervisor and return to NJPN using the fax number found on the form.

Your application is not complete!

Thank you for submitting your application. NJPN will email you shortly with additional information once your application has been reviewed.

If you work at a DMHAS-licensed substance abuse or mental health agency or state psychiatric hospital, download and fax the form below to complete the application process:

CPS Supervisor Confirmation Form

If you do not work at a DMHAS-licensed agency, you may disregard this form at this time.

Thank you.