Application Form – Recovery College

Dublin North, North East Recovery College

Please note the co-operative group learning spaces and course content we provide, support participants to move safely beyond their comfort zones. This may sometimes trigger emotional responses. While challenging, these responses provide great opportunities for personal growth. Our courses are open to applicants that are on different stages of the mental health and wellbeing spectrum including mental health service users, practitioners, family members and friends. When we receive your application form we will be in touch with you to ensure that the course adequately meets your needs.

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Course title*
Commencement date*
Date Format: MM slash DD slash YYYY
Please outline briefly what interests you about this particular course.
Is there anything that might impact on your full involvement on this course that you feel we should know about?*
Do you require any supports to participate fully on the course?*
Please identify your interest to enrol with the Recovery College by ticking one of the boxes provided (this information will remain confidential).*
- I have had experience of mental distress
- I am a supporter (Family member/Friend)
- I am a professional
- I have an interest in mental health recovery
Is there anything that might impact on either your access or involvement in the course that you feel we should know about?*
Our emancipatory approach to supporting personal transformation and recovery provides participants with an opportunity to explore mental health and wellbeing in ways that are diverse, holistic and sometimes challenging. Therefore all students have a personal and collective responsibility to supporting mutually respectful group spaces. Therefore all applicants must read and adhere to The Recovery College Student Charter and Code of Conduct - available online @ www.recoverycollege.ie/sign-up-for-a-course, or alternatively on request from the Recovery College Office.
Please read and sign: I have read the terms and conditions set out in the Dublin North, North East Recovery College Student Charter & Code of Conduct. These terms and conditions are available online or from the Recovery College Office www.recoverycollege.ie/sign-up-for-a-course. I agree that I may be contacted by telephone/ email regarding my application and that I will be asked to provide feedback about my experience at the Recovery College.
Email Subscription
- I would like to be added to the Recovery College Mailing List
This checkbox acts as an online signature*
- I confirm I agree