Volunteer Application/COA Training Scholarship

Thank you for your interest in City of Angels Recovery Training. If you are seeking financial assistance for training please complete this Scholarship/Volunteer Application as completely as possible. This information will be used in our decision in offering you a scholarship.

The more information we have in making that decision, the better the chances of being offered a scholarship. Please note items marked with a red * are required fields and need to be completed. This form will not allow you to submit without completing these items.

If you have any questions or comments please send email to info@cityofangelsnj.org

Name:*
Address:*
County:*
Home Phone:
-
Cell Phone:*
-
E-mail:*
How many hours are you available to volunteer?
What are the best time(s) available for you to volunteer?
Best Days to Volunteer?
Tell Us About Your Areas of Interest:
If you checked other in areas of interest, please use this area to explain:

~If you are only volunteering no other information is required you may submit now~

~If you are applying for a COA Training Scholarship please continue completing this application~

Scholarship Personal Information

How many years at the above location:
Marital Status:
Do you have children?
If Yes, How many boys?
If Yes, How many girls?
Birthday (optional)
Company Name:
Company Address:
Years with employer:
Are you currently in rehab or withdrawing from any illicit drug or alcohol?
Please select One:
Referred By:
Do you have an interest in any training scholarships?
Education:
Any Recovery Training to Date?
Explain Other:
From what Training Facility?
If you are requesting a scholarship now, please enter amount here $
What training course?

Scholarship Evaluation

How many volunteer hours are you willing to provide COA?
Is it your intention to participate as a recovery coach in the COA organization?
Do you currently have any recovery credits? Name them.
Is your annual income less than $25,000 Single, $50,000 Married?
Is there any other information that could be considered to expedite scholarship approval?