SIL Application

  • SIL Applicant

  • Format: (000) 000-0000.
  • SIL Locations Preferred.
  • Move In Date*
  • Are you 18 or older?*
  • What is your gender?*
  • What is your sexual orientation?*
  • How do you feel about having a roommate?*
  • I am able to follow chore schedule and keep house clean without supervision.*
  • I know how to respect other boundaries and choices.*
  • I get upset easily.*
  • Have you ever destroyed any property?*
  • Have you ever had an sexual allegations against you?*
  • Are you currently enrolled into school or have a job?*
  • Do you have any pending criminal charges?*
  • Do you have any medical diganoised conditions?*
  • Are you currently taking an Meds?*
  • Do you use or have you ever used illegal drugs?*
  • I like to consume Alcohol Beverages.*
  • I take things that does not belong to me.*
  • I am only applying for SIL because I have no other choice.*
  • Once accepted into SIL Program, if for any reason contract and rules are broken and I am asked to leave, depending on severity of situation, I will leave same day if asked, or by the timeframe given by the Director.*
  • Are you willing to participate in programs and activities provided by the SIL provider including life skills?*
  • Visitors, Alcohol, Drugs are Prohibited and a standard curfew is given with approved exceptions. Failure to comply may result in immediate eviction.*
  • I have reviewed Valuing Other Lives website, and received all the information pertaining to SIL Program and other services that are provided.*
  • Should be Empty: