Housing Scholarship Guidelines
Level 1 at 100% scholarship (Not to exceed 2 months) must include:
• Have completed at least 30 days of Residential Treatment AND/OR actively enrolled in a PHP or IOP program AND/OR 90/90 12 Step attendance
• Provide clean Urine Analysis and Breath Analysis at random and upon request
• Weekly verified meeting with one-on-one recovery mentor (Coach, Counselor, Sponsor etc.)
• Establishment of a community recovery program (12 step or other)
• Daily Recovery Activity (Clinical, 12 Step or other)
• Documentation of application to 5 jobs per week seeking secured employment
Level 2 at 75% scholarship must include:
• 25% of finances covered upfront
• Continued clean Urine Analysis and Breath Analysis at random and upon request
• Continuance/Completion of PHP or IOP program OR 90/90 12 Step attendance
• Weekly verified meeting with one-on-one recovery mentor (Coach, Counselor, Sponsor etc.)
• Establishment of a community recovery program (12 step or other)
• Daily Recovery Activity (Clinical, 12 Step or other)
• Documentation of application to 5 jobs per week seeking secured employment
Level 3 at 50% scholarship must include:
• 50% of finances covered upfront
• Continued clean Urine Analysis and Breath Analysis at random and upon request
• Continued bi-monthly one-on-one recovery mentor (Coach, Counselor, Sponsor etc.)
• Continuance/Completion of PHP or IOP program OR 90/90 12 Step attendance
• Continued participation in community recovery program (12step or other) 4/week
• Secured employment - annual income not to exceed $43,740
Level 4 at 25% scholarship must include:
• 75% of finances covered upfront
• Continued clean Urine Analysis and Breath Analysis at random and upon request
• Continued bi-monthly one-on-one recovery mentor (Coach, Counselor, Sponsor etc.)
• Continued participation in community recovery program (12step or other) 4/week
• Secured employment - annual income not to exceed $43,740
Housing Scholarship Application Form
Application Date: Date
First Name: Client first name Middle Name: Client middle name Last Name: Client last name
Address: Client Address
Cell Phone #: Client phone Email: Client email
Date of Birth: Client birthdate Recovery Date: Date
Current Employment Status: Paragraph
Current Monthly Income Amount: Text field
Current Monthly Family Income Amount (if under 25 years old): Text field
Do you have Medical Insurance?
Checkboxes
If Yes, who is your insurance provider? Text field
Is there any reason you cannot be employed?
Checkboxes
If Yes, provide reason: Paragraph
Have you received Recovery Living Community (RLC) scholarship funds at any other RLC in the last 24 months?
Checkboxes
If yes, describe what you received and where: Paragraph
What have you done to attempt to acquire funds for Recovery Living? Paragraph
Explain your need for financial assistance including how many months of support and level according to the Housing Scholarship Guidelines: Paragraph
I have read the scholarship guidelines, completed the above application, and certify that I qualify for scholarship award consideration. I understand that submission of an application does not guarantee scholarship funds. The organization will contact me within 1 week of application submission with a decision of approval or denial and the scholarship amount if awarded.
Applicant Signature: Signature Date: Date