Admission Application

The information requested in the following application is required for consideration of acceptance into The Fellowship Home. Information submitted herein is held in the strictest of confidence.

Overview

If you are a treatment provider, Case Manager, or Social Worker, please contact us after submitting this application; more information will be required.

The entire application process will take approximately 15 minutes. Simply follow the step-by-step instructions. At the bottom of every page, the data entered in the previous steps are displayed. To make corrections at any step in the process, just use your browser's BACK button to return to the previous step and change the data.

In the final step of the application process, all data entered will be displayed. Click the Submit button to submit your application via email. If you provide a valid email address, we will respond via email; otherwise, we will contact you (or your referrer) via the information provided. Upon submission, you will be contacted within two business days.