The Lay Leader training is four full days offered two days of one week and the same two days of the week following (e.g. a Monday and Tuesday and then the following Monday and Tuesday). Trainees must attend all four days of the training to earn certification. To gain and maintain Lay Leader status, trainees must co-facilitate their first 6-week workshop within 6 months (3 months is best practice), and co-facilitate one workshop every six months thereafter.

County of Residence

Which counties are you able to serve?

Which training would you like to attend?

Name:

Email Address:

Date of Birth (mm/dd/yyyy):

Address:

City, State, Zip:

Home Phone:

Other Phone:

  1. Are you interested in becoming a:
    Chronic Disease Self Management Program Lay Leader
    Diabetes Self Management Program Lay Leader
    Both
  2. Do you have a chronic health condition? Yes No
  3. Are you fluent in Spanish? Yes No
    or another language? Specify:
  4. Do you belong to any organizations that may want to host a Living Well Workshop? If so, please list organizational affiliations:
  5. Best days of the week to facilitate a workshop:
  6. Best time of the day to facilitate workshops:
    morning
    afternoon
    evening
  7. Have you ever taken the Chronic Disease Self-Management Workshop? Yes No
    If yes, please note date and location:
  8. Are you able to commit to co-leading one workshop (2 ½ hours once a week for six weeks) within six (6) months of completing the Lay Leader Training? Yes No
  9. Are you able to commit to co-leading at least one workshop (2 ½ hours once a week for six weeks) every six months (meaning at least twice a year) to maintain certification and for a duration of at least two years? Yes No

To reduce spam, what's two plus three?

Lay Leader Agreement:

You cannot teach the course until you have attended all four days of the Lay Leader Training.  Trainee leaders are required to make a commitment to teach at least two workshops in the State of Georgia.  Lay Leaders must teach the workshop only as outlined in the course manual.

I agree to the above, and I will teach in strict accordance with the course as written in the Leaders Manual, and as taught at leaders training.