CloverHouse Application for Membership

CloverHouse Application for Membership

To be accepted in a CloverHouse, an applicant must complete this application and be interviewed by the manager of the house.
Name*

First Name Last Name
Date of Birth*

MonthDayYear
Date
E-mail*
example@example.com
Phone Number*
Present Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Use this space to tell us relevant information related to your active addiction and recovery, including why you want to live here
I realize CloverHouse to which I am applying for membership requires (A) prohibit all members from using any alcohol or illegal drugs, (B) expel any member who violates such prohibition, (C) equally pay weekly guest fee, including any house voted expenses, and (D) utilize democratic decision making within the group including Inclusion and expulsion from the group. In accepting these terms, the applicant understands that conditions are different the the normal due process afforded by some local landlord-tenant laws.
I have read all of the material on this application form including the limitations set forth above. I have answered each question honestly and I have a desire to achieve comfortable recovery from substance use disorder.

Powered by Jotform SignClear
Should be Empty: