Single Moms Ministry Home Application
The StoneWater Ministry Homes gives a hand up to goal-oriented single moms who are working to overcome hardships by equipping them to create a foundation for permanent self-sustainability. Through our Christ-centered mentor program and church body support, women are empowered to remove barriers, attend classes for inner healing, sustain healthy community, and build lifelong skills, as they work to achieve their God-given potential.
Name
*
First Name
Last Name
Are you over the age of 21?
*
Yes
No
Birthday
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Have you attended StoneWater 101?
*
Yes
No
I don't know what that is
Are you a StoneWater Church member? (a member is someone who has attended 101 and is actively in a group)
*
Yes
No
Are you currently in a StoneWater group?
*
Yes
No
What is the name of your group? Who is your group leader?
Have you ever applied for StoneWater Single Moms Ministry Homes before?
*
Yes
No
Have you ever been convicted of a crime?
*
Yes
No
If yes please explain
*
What is your marital status?
*
Single
Separated
Divorced
Widowed
Do you have a minimum of a high school diploma or GED?
*
Yes
No
Are you enrolled in higher education?
*
Yes
No
This is my dream
Do you have any active addictions or had any addictions in the past?
*
Yes
No
If yes, have you sustained sobriety for the last three years?
*
Do you currently drink alcohol, smoke, or vape?
*
Drink
Smoke
Vape
None of the above
Do you have a valid Texas drivers license?
*
Yes
No
Do you have reliable transportation?
*
Yes
No
Are you a U.S. citizen or permanent resident and fluent in English?
*
Yes
No
Are you pregnant?
*
Yes
No
Do you have children?
*
Yes
No
Do you have any active CPS cases against you?
*
Yes
No
How many children currently live with you?
*
Please Select
1 Child
2 Children
3 Children
4 Children
1st Child's Name
*
First Name
Last Name
1st Child's Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
2nd Child's Name
*
First Name
Last Name
2nd Child's Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
3rd Child's Name
*
First Name
Last Name
3rd Child's Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
4th Child's Name
*
First Name
Last Name
4th Child's Birthday
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
How many days a week do you have your kids? What is your custody agreement?
*
Are you currently working?
*
Yes - full time
Yes - part time
No
Where are you currently employed?
*
Are you ready, willing and able to work full time?
*
Yes
No
Do you have the ability to produce a family-sustaining wage?
*
Yes
No
Do you have a personal relationship with Jesus?
*
Yes
No
Do you have a testimony or time when you committed to follow Christ and tell us how it changed your life?
*
Why are you applying to The StoneWater Single Moms Ministry home?
*
How would you benefit if given the opportunity to live in the Single Moms homes?
*
Did someone refer you to The StoneWater Single Moms Ministry Home or assist you with this application?
*
Yes
No
Who referred you? Please list their name.
*
Please tell us a little bit about your personality so we can best pair you with a mentor should you be given this opportunity.
*
Submit
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