AAQITAUVIK

Steps To Freedom Application
Thank you for applying to Aaqitauvik's Steps to Freedom Program. This is an approximate 3 week program, with sessions focusing on healing from past trauma, wounding and resulting addictions.
**EACH APPLICANT IS RESPONSIBLE TO ARRANGE AND PROVIDE THEIR OWN FLIGHT, HOUSING AND FINANCIAL NEEDS WHILE THEY ARE STAYING IN QUAQTAQ FOR THE PROGRAM. **HOUSING MUST BE ARRANGED AND CONFIRMED BY THE HOMEOWNER TO THE AAQITAUVIK OFFICE BY PHONE OR EMAIL, BEFORE AN ACCEPTANCE LETTER WILL BE ISSUED.
If you have further questions, you can contact our office at 819-492-9145 or email us at manager@aaqitauvik.ca
Guidelines

Guidelines outlining the requirements for potential individuals attending our program
All potential participants must be in agreement with all of the above to be considered for our Program.
1. Individuals must have demonstrated personal motivation in attending other self-help groups within the Correctional system, or they must have shown motivation to fulfill the guidelines of the Social Services system. It is these individuals Aaqitauvik is looking to assist.*

I have read this
2. While attending the program, if a participant is found to be under the influence of alcohol or drugs (marijuana included) they will be asked to leave the program until such time as they are ready to work towards their healing/recovery. There will be zero tolerance for this. *

I understand there will be zero tolerance for this
3. If the participant is absent three sessions (not days) consecutively without notice to the AHC office, their contact person, ie Social Worker or Lawyer will be notified. Appropriate action will be taken. They will also be asked to retake the program.*

I understand my contact person will be notified, and appropriate action will be taken. I also understand that I will be asked to retake the program.
4. Participants will attend 2-2.5 hour sessions each morning & afternoon & will attend Monday to Friday weekly.*

I agree to this
5. Participants are required to cover the following costs: travel to and from Quaqtaq, food, accommodation arrangements and housing costs. Participants must understandand that any and all other financial needs incurred will be the responsibility of each participant.*

I understand
6. Participants must provide a phone number or a way for them to contact Aaqitauvik Healing Centre while they are in the community, so they can provide valid reasons for absences to sessions. We require the Participants’ contacts phone number and email. Aaqitauvik takes attendance at each session. It is the individual’s responsibility to inform Aaqitauvik of any absence during the program*

I agree to provide Aaqitauvik wth both phone number
7. AHC reserves the right to advise the Participant that their chosen housing is unsuitable for them during the program. The environment may not supportive contribute to the individuals healing process.*

I understand
Registrant
Why do you feel this program will help you?*
Location:*
Dates:*
Name of Registrant:*
Number & Street Name or PO Box:*
Community:*
Province:*
Postal Code:*
Cell or Phone:*
Please enter a valid phone number.
Email:*
Date Of Birth:*
Gender:*
Marital Status:*

SingleMarriedSeparatedDivorced
Lawyer/Social Worker
Name of Contact for Lawyer or Social Worker's Name:*
Contact Email:*
Contact Phone Number:*
Please enter a valid phone number.
Reason for Incarceration:*
I understand and agree that there will be group pictures taken during the program. I give my permission that any photo with my picture in it can be used in promotional purposes for Aaqitauvik Healing Centre
Click here:*

AgreeDo Not Agree
Address During Program
Homeowner:*
Number & Street Name or PO Box:*
Community:*
Phone # of Homeowner:*
Please enter a valid phone number.
Emergency Contact
Name:*
Relationship to You:*
Day Phone Number:*
Please enter a valid phone number.
Night Phone Number:*
Please enter a valid phone number.
Please verify that you are human*
Should be Empty:

Steps To Freedom Application

Thank you for applying to Aaqitauvik's Steps to Freedom Program. This is an approximate 3 week program, with sessions focusing on healing from past trauma, wounding and resulting addictions.

**EACH APPLICANT IS RESPONSIBLE TO ARRANGE AND PROVIDE THEIR OWN FLIGHT, HOUSING AND FINANCIAL NEEDS WHILE THEY ARE STAYING IN QUAQTAQ FOR THE PROGRAM. **HOUSING MUST BE ARRANGED AND CONFIRMED BY THE HOMEOWNER TO THE AAQITAUVIK OFFICE BY PHONE OR EMAIL, BEFORE AN ACCEPTANCE LETTER WILL BE ISSUED.

If you have further questions, you can contact our office at 819-492-9145 or email us at manager@aaqitauvik.ca

Guidelines

Registrant

Lawyer/Social Worker

I understand and agree that there will be group pictures taken during the program. I give my permission that any photo with my picture in it can be used in promotional purposes for Aaqitauvik Healing Centre

Address During Program

Emergency Contact

EACH APPLICANT IS RESPONSIBLE TO ARRANGE AND PROVIDE THEIR OWN FLIGHT, HOUSING AND FINANCIAL NEEDS WHILE THEY ARE STAYING IN QUAQTAQ FOR THE PROGRAM. HOUSING MUST BE ARRANGED AND CONFIRMED BY THE HOMEOWNER TO THE AAQITAUVIK OFFICE BY PHONE OR EMAIL, BEFORE AN ACCEPTANCE LETTER WILL BE ISSUED.