To attend the next training session, please complete the following form.  

  • The application will be sent directly to Nikki Kontz, Clinical Coordinator.  

  • Bring the signed parent consent form with you to the first day of training.  

  • To find out when the next Peer Counselor training is, please call 602-248-8336.

  • Before the first day of training, please download and print the parent consent form and have your parent/guardian fill it out. 

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You will need Adobe Reader to download the Parent Consent form.  Click on the icon to download

PHASE 1

PHASE 2

PHASE 3

Introduction to Teen Lifeline and the skills needed to take hotline calls.

Dates:  _________ & __________
(Sat. and Sun. from 9a.m. – 4p.m.)

5 additional sessions scheduled from 3p.m.-9p.m. over a period of five weeks on any day of the week.  This is completed prior to Phase 3.

Two follow-up sessions will be held dealing with a variety of problems faced by teenagers. 

Dates:  _________ & __________
(Sat. and Sun. from 9a.m. – 4p.m.)

  • The hotline is located at a confidential address, which will be disclosed during Phase 1 of training. 

  • After all three phases of training have been completed, you will be reviewed for eligibility to work on the hotline.

  • We ask that all teens that complete training make  a four month commitment to the program once training is complete.  As part of this commitment, we ask that you agree to work on the hotline a minimum of 15 hours a month (approx. 2-3 shifts)

  • The hotline is staffed by Peer Counselors from 3p.m. to 9p.m. You will be asked to come in during these six hour shifst to work on the hotline.

Volunteer Information
*Volunteer First Name: *Volunteer Last Name:
*Address:
*City:
State:  AZ    (you must be a resident of Arizona)
*Zip code:
*Telephone:
*Email:
Birthday:
*Age: You must be at least 15 years old to start Peer Counselor training.
School:
Year in School Freshman    Sophomore   Junior    Senior    College   
Person to Notify in Case of Emergency
First Name: Last Name:
Address:
City:
State:
Zip code:
Home Telephone:
Work Telephone:
Relationship:
Name of Parents/Guardians:  
Other Information
1.  Do you have time to be a Peer Counselor?  YES    NO

2.  Briefly list your hobbies or interests:
3.  List any after-school commitments or responsibilities you have (work, family, sports, clubs, etc.)
4.  Briefly explain your interest or motivation in becoming a Peer Counselor:
5.  What problems are teens facing today?  How can Teen Lifeline help?

6.  Can you realistically make a commitment to Teen Lifeline?

7. Have you had an experience with counseling before?

8. How would you respond to a 15-year-old girl who is having a problem with her boyfriend?  Lately he doesn't seem to be interested in her and she feels shut out, alone and confused.  She doesn't know what to do.

9. What is the role of a Peer Counselor?

**REMINDER:  To attend training, you must download the Parent Consent Form and bring a signed copy to the first day of training.**
When you have completed the application, click on the submit button to send it to the Clinical Coordinator.