Character-Personal Recommendation For Certification Form - Florida Certification Board Page 2
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3Certified Recovery Peer Specialist
Character-Personal Recommendation for Certification Form
Part 1: To be completed by the applicant before to giving to the individual providing the Professional Recommendation for
Certification as a Recovery Peer Specialist (CRPS).
Applicant Information.
Please list your name and the name of the individual completing this form, as stated on your Application for Certification.
Use a separate form for each individual providing a professional recommendation for certification.
Your name:
Name of individual providing the recommendation:
Part 2: To be completed by the individual providing the applicant with a Recommendation for Certification as a Recovery Peer
Specialist.
Section A: Contact Information. Please write “none” or “N/A” as necessary.
Last Name
First Name
home cell work
Primary Email Address
Primary Phone Number
Phone Type
Contact Address Line 1
City
State
Zip code
County
Title
Employer
Employer Webpage Address
Business Phone
Section B: Nature of Relationship with Applicant for Certification. Attach additional pages if necessary.
Please describe the nature of your relationship with the applicant, including how you are eligible to provide the applicant with
a Character/Personal Recommendation for Certification as a Recovery Peer Specialist (CRPS).
Florida Certification Board (FCB)
CRPS Character/Personal Recommendation Form
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