Renewed Hope Ministries is a voluntary program. For the spiritual, physical, and emotional well-being of all participants, there are rules and restrictions in place. Please see the Resident Handbook for more information.
Have you ever attended church or belonged to a religious organization?
Are you currently attending a church or religious organization?
Have you ever had a sexually transmitted disease?
Have you ever suffered from depression?
Have you ever been treated for any psychiatric illnesses?
Have you ever considered suicide?
Have you ever attempted suicide?
Alcohol & Drug Use History
Please list any rehabilitation programs you have attended and if you completed them:
Do you use products containing nicotine (i.e. cigarettes, dip, vape, etc.)?
Please list from newest to oldest all charges, dates of arrest, and time served:
Have you ever been charged with any sexual crime?
Are there any current charges pending against you?
Are you currently on probation or parole?
Have you come to this program on your own free will?
Are you court ordered into this program or any program?
I have read and agree to abide by the Renewed Hope Ministries Resident Handbook, which includes a list of approved clothing and personal items, rules and regulations, disciplinary actions, drug screening policies, and our statement of faith.
I, the undersigned, do solemnly swear the above statements are an expression of my own desire to overcome my addiction to drugs and alcohol, that this application was completed voluntarily, and that the statements contained therein are true and complete to the best of my knowledge.