FSP Training Registration – Missouri Family Support Provider

Family Support Provider Training Application

Important Notice to Applicants
According to Missouri Credentialing Board (MCB) Policies and Procedures, the following rules apply to those seeking a MCB credential.
1. The following items disqualify an individual from obtaining the FSP with the MCB: A. Is listed on the Department of Mental Health disqualification registry B. Is listed on the employee disqualification list of the Dept. Health and Senior Services or Dept. of Social Services C. Any crime against a minor D. A person who has been convicted of, found guilty to, plead guilty to or nolo contendere to any of the Disqualifying Crime (s) Pursuant to Section 630.170, RSMo. The crime (s) will only disqualify an applicant if the crime (s) were a felony. Please view information about Section 630.170, RSMo on the MCB web site www.missouricb.com under the Disqualifying Crimes Link.
2. If an individual has applied for and been given an exception from the Department of Mental Health, the individual may apply for an MCB credential. Please send in proof of exception with your application.
3. If an individual will not be working in a Department of Mental Health certified agency and would still like to be credentialed, the individual may apply directly to the Missouri Credentialing Board exceptions committee.
Acknowledgement of MCB’s Policy and Procedures regarding obtaining an exception from either the Department of Mental Health or the Missouri Credentialing Board.*
- I acknowledge I have read and understand MCB’s Policy and Procedures regarding obtaining an exception from either the Department of Mental Health or the Missouri Credentialing Board. If I am denied an exception from either agency, I am not entitled to a refund, as the $75.00 fee was for the training and not the Family Support Provider training application.
In order to attend this training you must have proof of a High School Equivalency (HSE) diploma or higher. Do you have a HSE or higher?*
- Yes
- No
If you do not have proof of a High School Equivalency (HSE) diploma or higher please contact the Missouri Credentialing Board, 573.616.2300, help@missouricb.com, for further assistance.
Your Name*
First Middle Last
Your Email Address:*
Your Phone Number:*
Please list a number where we may contact you.
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
1. List the county in which you reside.*
2023 FSP Training Dates
Please select a training date preference below.
2. Which Training Date would you prefer?*
Please select a training date preference
- May 9-11, 2023 - FACT (Family Advocacy and Community Training), 2240 Bluestone Dr., St. Charles, MO 63303
3. Are you currently employed?*
- Yes
- No
If yes, please list your place of employment.*
(Note: an employment history is not necessary for consideration.)
4. Do you have any Dietary Restrictions? Please be specific.*
5. Are you someone with lived experience with a family member with a mental health, substance use, or developmental disability? For this credential, you must have experience with a family member with this experience.*
- Yes
- No
If you do not have lived experience with a behavioral health disorder. please contact the Missouri Credentialing Board, 573.616.2300, help@missouricb.com, for further assistance.
6. What is your personal definition of family resilience?*
7. Helping families in recovery from a behavioral health challenge can be very intense work. The core principle of peer support is sharing lived experience. Are you at a point with your family that qualifies you to assist other families in building resilience?*
- Yes
- No
How do you know?*
8. Are you willing to disclose to peers, staff, and the general public that you have lived experience with your family?*
- Yes
- No
9. You will be expected to participate in discussions, real-plays, and small groups using elements of your own family’s recovery story. Are you comfortable sharing your recovery with others during this training?*
- Yes
- No
10. You will also be required to listen to the stories of lived experience in other families. Sometimes these stories are uncomfortable and could make you feel re-traumatized. Are you okay with this?*
- Yes
- No
11. The required training is intensive and can be fatiguing. Do you feel you generally have the energy to stay alert and focused?*
- Yes
- No
12. Describe how your own family’s recovery and resiliency journey has helped you to get where your family is today.*
13. What are some things you do on a regular basis to maintain your level of resilience with your family?*
14. Describe two of your strengths and how they have helped your family to get where you are today.*
15. What is your plan to deal with hard stories with the families you serve and avoid re-traumatizing yourself? This can cause a relapse in your family. How will you avoid this?*
16. Describe your best experience in employment, service work, or volunteer work, and what made it meaningful to you.*
17. Describe your support team and this helped you in your family recovery.*
18. Describe why you want to work with families as a Family Support Provider. (FSP)*
19. Is there anything else you would like us to know?*
Test Monitor Information
Please provide a name, phone number, and email address of someone who will be able to serve in the capacity of a test monitor while you take the required online exam after you complete the training. A proctor does not need to be a technical expert, nor does the proctor need to hold an FSP certification. However, the Missouri Credentialing Board does require they have a “professional” relationship with the applicant. (a supervisor, sponsor, minister, etc)
Hidden
Important Test Monitor Information
Important Test Monitor Information: Please provide a name, phone number, and email address of someone who will be able to serve in the capacity of a test monitor while you take the required online exam after you complete the training. A proctor does not need to be a technical expert, nor does the proctor need to hold an FSP certification. However, the Missouri Credentialing Board does require they have a “professional” relationship with the applicant. (a supervisor, sponsor, minister, etc)
Important Test Monitor Information: Please provide a name, phone number, and email address of someone who will be able to serve in the capacity of a test monitor while you take the required online exam after you complete the training. A proctor does not need to be a technical expert, nor does the proctor need to hold an FSP certification. However, the Missouri Credentialing Board does require they have a “professional” relationship with the applicant. (a supervisor, sponsor, minister, etc)
Test Monitor's Name*
Please do not put your name in this section.
First Last
Test Monitor's Phone Number*
Test Monitor's Email*
I consent to my submitted data being collected and stored by the Missouri Credentialing Board*
- yes
FSP Participant Training Contract
Hidden
Important TestInformation
FSP Participant Training Contract: I understand that the FSP training is a professional training and that I will be held to professional training standards that have been set by the Missouri Credentialing Board. I further understand that if I do not adhere to the standards listed below, I may be asked to leave the training by the instructor and no refund will be issued.
Expectations for the Training
- You must attend all training sessions. If an emergency arises you are allowed to miss up to two hours total. If you miss more than two hours, you are not eligible to receive a certificate of completion nor take the exam. (This includes reporting late, extra time out for breaks/lunches, etc. Time away from the training is designed for emergency situations only and must have been approved by the trainers—this does not give you the ability to leave early from the training if you attended all week).
- Actively engage in training sessions. Be alert and attentive to presenters and activities. Don’t be disruptive. Wait until after training sessions to have all non-training-related conversations. (If you are sleeping—you are not participating). For virtual trainings, you must have your camera turned on and the instructor must be able to see you on camera at all times. If you are not actively participating in sessions and on camera at all times, you will be considered absent.
- Be respectful and courteous in all presentations.
- Turn off cell phones during presentations. Do not use telephones or text messaging during training sessions. (You will be able to check cell phones, emails, etc. during you hourly breaks or during lunch).
- Turn off any personal music players, electronic organizers, and other electronic devices during presentations.
- Personal Hygiene—During this training you are expected to always present yourself in a professional manner. It’s a large part of appropriate business conduct. The training rooms are often small and therefore be aware of others around you. Examples would include: daily baths or showers, using deodorant, hair-washing and avoiding offensive personal habits such as spitting and passing gas. Hand washing and the use of hand sanitizers has gained importance as a protection against the spread of illnesses. If you do wear perfume, please ensure that it is to a minimum as some attendees may have allergies to certain fragrances.
- If the trainer believes you are under the influence of any substance you will be removed immediately from the training.
- If you are removed from the training for any reason, your proctor will be notified by the Missouri Credentialing Board.
- It is at the discretion of the trainers as to whether an attendee will be removed from the training and no refund will be issued by the Missouri Credentialing Board.
- I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
- You must fill out an evaluation at the conclusion of the training in order to receive your training certificate. Please note that a training certificate is not the same as being a credentialed peer.
- Therefore, after the training you understand you must pass the FSP exam and then in order to become a credentialed peer, you must complete the Family Support Provider application and submit to the Missouri Credentialing Board for review. Once you are approved you will receive a welcome letter from the MCB as well as a FSP credentialing certificate.
I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
I understand that the FSP training is a professional training and that I will be held to professional training standards that have been set by the Missouri Credentialing Board. I further understand that if I do not adhere to the standards listed below, I may be asked to leave the training by the instructor and no refund will be issued. Expectations for the Training You must attend all training sessions. If an emergency arises you are allowed to miss up to two hours total. If you miss more than two hours, you are not eligible to receive a certificate of completion nor take the exam. (This includes reporting late, extra time out for breaks/lunches, etc. Time away from the training is designed for emergency situations only and must have been approved by the trainers—this does not give you the ability to leave early from the training if you attended all week). Actively engage in training sessions. Be alert and attentive to presenters and activities. Don’t be disruptive. Wait until after training sessions to have all non-training-related conversations. (If you are sleeping—you are not participating). For virtual trainings, you must have your camera turned on and the instructor must be able to see you on camera at all times. If you are not actively participating in sessions and on camera at all times, you will be considered absent. Be respectful and courteous in all presentations. Turn off cell phones during presentations. Do not use telephones or text messaging during training sessions. (You will be able to check cell phones, emails, etc. during you hourly breaks or during lunch). Turn off any personal music players, electronic organizers, and other electronic devices during presentations. Personal Hygiene—During this training you are expected to always present yourself in a professional manner. It’s a large part of appropriate business conduct. The training rooms are often small and therefore be aware of others around you. Examples would include: daily baths or showers, using deodorant, hair-washing and avoiding offensive personal habits such as spitting and passing gas. Hand washing and the use of hand sanitizers has gained importance as a protection against the spread of illnesses. If you do wear perfume, please ensure that it is to a minimum as some attendees may have allergies to certain fragrances. If the trainer believes you are under the influence of any substance you will be removed immediately from the training. If you are removed from the training for any reason, your proctor will be notified by the Missouri Credentialing Board. It is at the discretion of the trainers as to whether an attendee will be removed from the training and no refund will be issued by the Missouri Credentialing Board. I understand the training fee is nonrefundable and cannot be transferred to another training date or location. You must fill out an evaluation at the conclusion of the training in order to receive your training certificate. Please note that a training certificate is not the same as being a credentialed peer. Therefore, after the training you understand you must pass the FSP exam and then in order to become a credentialed peer, you must complete the Family Support Provider application and submit to the Missouri Credentialing Board for review. Once you are approved you will receive a welcome letter from the MCB as well as a FSP credentialing certificate.
FSP Participant Training Contract: I understand that the FSP training is a professional training and that I will be held to professional training standards that have been set by the Missouri Credentialing Board. I further understand that if I do not adhere to the standards listed below, I may be asked to leave the training by the instructor and no refund will be issued.
Expectations for the Training
- You must attend all training sessions. If an emergency arises you are allowed to miss up to two hours total. If you miss more than two hours, you are not eligible to receive a certificate of completion nor take the exam. (This includes reporting late, extra time out for breaks/lunches, etc. Time away from the training is designed for emergency situations only and must have been approved by the trainers—this does not give you the ability to leave early from the training if you attended all week).
- Actively engage in training sessions. Be alert and attentive to presenters and activities. Don’t be disruptive. Wait until after training sessions to have all non-training-related conversations. (If you are sleeping—you are not participating). For virtual trainings, you must have your camera turned on and the instructor must be able to see you on camera at all times. If you are not actively participating in sessions and on camera at all times, you will be considered absent.
- Be respectful and courteous in all presentations.
- Turn off cell phones during presentations. Do not use telephones or text messaging during training sessions. (You will be able to check cell phones, emails, etc. during you hourly breaks or during lunch).
- Turn off any personal music players, electronic organizers, and other electronic devices during presentations.
- Personal Hygiene—During this training you are expected to always present yourself in a professional manner. It’s a large part of appropriate business conduct. The training rooms are often small and therefore be aware of others around you. Examples would include: daily baths or showers, using deodorant, hair-washing and avoiding offensive personal habits such as spitting and passing gas. Hand washing and the use of hand sanitizers has gained importance as a protection against the spread of illnesses. If you do wear perfume, please ensure that it is to a minimum as some attendees may have allergies to certain fragrances.
- If the trainer believes you are under the influence of any substance you will be removed immediately from the training.
- If you are removed from the training for any reason, your proctor will be notified by the Missouri Credentialing Board.
- It is at the discretion of the trainers as to whether an attendee will be removed from the training and no refund will be issued by the Missouri Credentialing Board.
- I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
- You must fill out an evaluation at the conclusion of the training in order to receive your training certificate. Please note that a training certificate is not the same as being a credentialed peer.
- Therefore, after the training you understand you must pass the FSP exam and then in order to become a credentialed peer, you must complete the Family Support Provider application and submit to the Missouri Credentialing Board for review. Once you are approved you will receive a welcome letter from the MCB as well as a FSP credentialing certificate.
I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
Signature
Signature*
My initial affirms that all of the information contained in this application is true and correct to the best of my knowledge and has been completed by no other person. I understand that knowingly providing false information shall be grounds to deny my certification. I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
Payment Information
I acknowledge I have read and understand MCB’s Policy and Procedures regarding obtaining an exception from either the Department of Mental Health or the Missouri Credentialing Board. If I am denied an exception from either agency, I am not entitled to a refund, as the $75.00 fee was for the training and not the Family Support Provider application.
I understand the training fee is nonrefundable and cannot be transferred to another training date or location.
FSP Training Application Fee*
- FSP Training Application Fee - $75
Do You Have Coupon? Please submit here.
Total
$0.00
Credit Card
Card Details
Cardholder Name
Email
This field is for validation purposes and should be left unchanged.

Family Support Provider Training Application

Important Notice to Applicants

2023 FSP Training Dates

Test Monitor Information

FSP Participant Training Contract

Signature

Payment Information

Missouri Family Support Provider

Missouri Youth Peer Support

Get Notifications of Upcoming Courses Straight to Your Inbox

This website uses cookies to ensure you get the best experience on our website.