APPLICATION

To apply to one of our programs fill out the form below.

Download a copy of the application:  TFH Application.

If you are a professional, making a referral, please continue to this section.

THE FELLOWSHIP HOME OF WINSTON-SALEM, NC, INC.

  • Personal Identification Information

  • Please enter a value between 1 and 100.

  • Emergency Contact

  • Financial Position

  • Military Service

  • Legal History

  • Please enter a value between 0 and 100.

  • Substance History

  • Current Health

  • The information presented above is true and correct to the best of my knowledge. Presenting false or misleading information could be grounds for immediate termination from The Fellowship Home.

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