Disqualifying Factors:

1. Individuals who have records of violent or sex offenses, which present a risk to the community. 

2. Individuals with legal restraints which would prohibit them from participating in the program, beyond which can be sorted out by our admissions office with the legal authority. 

3. Individuals with medical problems which require excessive time away from our residential program. 

4. Individuals taking psychotropic medications (mind-altering, mood altering medications, sleep aids, etc.)

**If you do have minor children, please fill out the child information pages for EACH child listed.

**If you do not have children, please continue to the academic history section of the application. 

Disclaimer: Home of Hope reserves the right to prohibit entrance to individuals taking psychotropic medications (mind and/or mood-altering medications). Please consult with your doctor before safely tapering off of such medications prior to entry into our program.

Please Note: All students accepted into Home of Hope must have a tuberculosis test administered. RESULTS of that test must be submitted on the day of entry.

The undersigned student applicant fully acknowledges that the information provided herein is accurate and true to the best of her knowledge, and the application form has been completed and filled out by the student applicant. The student applicant further understands that any false or incomplete information may cause and result in disqualification from admittance or continuation in the program.