Application: Meeting Facilitator

Name*

First NameLast Name

Primary Email Address*

Confirmation Emailexample@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

YesNo

If yes, please explain

RECOVERY BACKGROUND

YesNo

How long have you been in sobriety?*

If you are not currently sober, when was your most recent sober period (90+ days) and how for long did that period last? What were the events that caused you to relapse and the steps you are taking now to maintain sobriety?

YesNo

How long have/had you been a SheRecovery Member? Type N/A, if not applicable.*

YesNo

Describe your history in recovery—your primary struggle, how long this has been an issue for you, and your attempts at getting well in the past.*

Please honestly describe your relationship with SheRecovery, including any positive or negative experiences you may have had and/or any concerns you have about facilitating a meeting.*

PERSONAL RELATIONSHIP WITH JESUS

YesNo

Describe your personal relationship with Jesus Christ.

Why do you feel you would make a great addition to the team?*

AGREEMENT

I, the undersigned applicant, understand Living on Purpose is the parent organization for SheRecovery and my employment will be as a contractor.

I, the undersigned applicant, hereby certify that the information contained on this Application for Employment is true and correct, and I have not omitted any facts, which I reasonably believe would reflect unfavorably on Living on Purpose's decision to hire me.

I, the undersigned applicant, understand my employment may be terminated by either the employee or the employer at any time, with or without notice and with or without cause.

I, the undersigned applicant, understand if my application is selected for consideration, I will have a phone interview with Crystal Renaud Day, and/or another member of the Living on Purpose team.

I, the undersigned applicant, understand that due to the sensitivity required for this position, a background check may be conducted prior to hire.

By typing your signature below, you consent to your understanding and agreement of the terms and policies above.

Signature*

Today's Date*

MonthDayYear

Application for SheRecovery Meeting Facilitator