Apply for Housing

The cornerstone of your path to successful recovery begins with your determination to conquer addiction. No one can force recovery upon you. Our recovery homes welcome and support those committed to changing lives, positively impacting themselves and the people around them.

Name

Phone

Income (Who will be paying for your stay?)

Working

Family

Agency

Other

Who is completing this appication?

Self

Case Manager

Family Member

Other

Where do you work currently? If not employeed, what kind of job will you be looking for?

How soon do you plan to move in?

Have you ever lived in a Sober Living Home before? If yes, which Sober Living Home have you stayed and for how long?

What are you recovering from? And how long have you been sober?

Tell us about your family or friends - do you have anyone you can call in case of an emergency?

Are you working with any organizations or case managers who are helping you with resources?

Have you had any criminal history of violence, sexual offence, or arson? ( Your response will be reviewed on a case-by-case basis)

What should we know about you - tell us about yourself, and why do you want to stay at our home?

Your Social Security Number

Upload an image of your ID

I have read theHouse Rules

Thanks for submitting your application!

A team member from Shalom House will contact you within the next 24 hours.

Have a wonderful day!