Mental Health Champions 2021

Enrolment Form

This six-week course is open to all local people with an interest

in mental health wellbeing and helping others.

Name:
Address:

Phone number
Email address:

Please tick here to confirm which course you would like to attend
Mental Health Champions, Mental Health Champions,
Blanchardstown Area Wider Fingal Area
th
Starting Monday January 18 @ 10am Starting Tuesday January 19th @ 10am

Please outline very briefly, what interests you about this course.

Is there anything that might affect your full involvement on this course
that you feel we should know about?
.
 Mental Health Champions 2021
Enrolment Form

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 I have an interest in I am a supporter I am a professional
mental distress mental health wellbeing
& recovery (Family working in the area
member/Friend)

Have you used Zoom to access online meeting, courses or groups

before? Please note we will follow up with anyone looking for support to
set up. Please also feel free to add any additional comments here

Thanks for taking the time to complete this application form. Further to
submission of this application, one of the Recovery College team will
follow up with a phone call to get you set up on the course.
 Mental Health Champions 2021
Enrolment Form

Please note all participants have a personal and collective responsibility

to support mutually respectful group learning spaces. Therefore, all
applicants must read and adhere to The Recovery College Student
Charter – which will be circulated in advance of the course start date.

Please direct any questions to:

DCU, DUBLIN

The Recovery College

Healthy Living Centre
Dublin City University
Glasnevin
Dublin 9.
Email: recoverycollege@dcu.ie
Phone: 017007907