• Adult & Teen Challenge Baltimore

    Men's Center Application
  • Disqualifying Factors:

    1) Individuals who have records of sex offenses which may present a risk to the community due to the City of Baltimore's regulations and restrictions. 

    2) Individuals with legal restraints which would preclude them from participating in the program and which cannot be sorted out by our Admissions office with the legal authority.

    3) Individuals with medical problems which requires excessive time away from our residential program and/or unable to particpate in our work therapy program. 

    4) Individuals taking mind altering or mood changing drugs.

    You Must Agree to the Following:

    1.Are you willing to give up all legal and illegal drugs and alcohol

    2. Are you willing to give up all narcotic and or psychotropic medications. (Anti-Depressants, Anxiety, ADHD, Bi-Polar, Schizophrenia) *With Doctors Approval*

    3. Are you willing to give up all nicotine products?

    4. Are you willing to give up all contact with friends, girlfriends, fiancés to only focus upon yourself and reconciliation with immediate family only?

    5. Are you willing to not have access to your cell phone or any other electronics while being enrolled?

    6. Are you willing to stay enrolled the minimum one year in order to graduate?

    CLICK HERE TO PLEASE READ OUR STUDENT HANDBOOK

  • Personal Information

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  • Family History


  • Legal History

  • History of the Drug Abuse

  • Treatment History

  • Spiritual History


  • Personal History

  • Disclaimer: Adult & Teen Challenge Baltimore reserves the right to prohibit entrance to individuals taking mind and/or mood- altering medications (e.g., Lithium, Prozac, Haldol, Ritalin, Valium, etc.)

    Please note: All medications used to treat depression, anxiety, pain and sleep disorders or other psychological problems are carefully screened at Adult & Teen Challenge Baltimore. Please consult your doctor before considering entry.

  • Personal Questions:

    Please fill these out with great effort and honesty.

  • AGREEMENTS

  • Signature and Submission

  • By signing this applicaton and submitting it you are agreeing that all the information filled in is true and correct to the best of my ability. I understand that if I we're to put incorrect or false information on this application it could result in denial of the application and or dismissal from the program at a further date. 

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