• Restoration House Application

  • Instructions: Please ensure you have a sufficient amount of time to complete this application. Applications submitted incomplete will be rejected. Write None or N/A in blanks that don't apply to you. This form will take a minimum of 45 minutes to complete.

  • SECTION 1: SUITABILITY


    Restoration House is a rigorous, highly accountable Residential Recovery Support Services Program. It is not for everyone. Restoration House is literally an honest-to-God Program for men and women so sick & tired of being sick & tired that they will do whatever it takes to find a better way to live. If your way worked, you wouldn’t need what we offer. All who humble themselves and work this Program our way discover their past redeemed, their present transformed, and their future restored. Our way involves honesty & accountability in all things and relational abstinence for the duration. To determine whether Restoration House is right for you, check ONLY the boxes of those policies you KNOW you can live with for at least six months. Mismatches between people & programs never end well.

  • EVERYONE ENTERS AT LEVEL 1. Level 1 Boundaries include:

  • Before moving on to the next page of the application, please read the following statement carefully and sign below:

    "I swear or affirm I have been honest in my responses to all information requested herein. I give my consent to CrossBRIDGE to confirm all information provided."

     

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  • Section 2: Personal Background

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  • Alcohol/ Drug Use

  • Gang Affiliation

  • Housing & Jobs

  • Finances

  • $190 Deposit required of all Applicants except those pre-approved for RHP: $150 for First Week Program Fee & $40 for MTA I.D. & Monthly Bus Pass.

  • YOU WILL NOT RECEIVE AN ACCEPTANCE LETTER UNTIL WE RECEIVE A DEPOSIT OR VERIFY VALID ARRANGEMENTS.

  • Relational

  • Other

  • *Valid license, insurance, registration & PRIOR STAFF APPROVAL are required before operating ANY motorized vehicle (including cycles, bikes, scooters, ect.) while in the Program.

  • Section 3: Criminal Justice Background

  • A. PENDING

  • B. CURRENTLY INCARCERATED


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  • C. PRIOR CONVICTIONS

  • ALL APPLICANTS MUST COMPLETE:

  • “I swear or affirm that my responses are true, accurate, and complete in every respect. I understand that Program acceptance, if granted, is conditioned upon the veracity of my responses. If accepted, I will promptly notify Restoration House Staff if any information provided in this Application changes. I further understand that acceptance does not guarantee a specific entry date; my entry date will depend upon availability of bed space.”

  • Clear
  • Should be Empty: