Addendum to Family Resident Agreement for Client first name Client last name

Address Listing for Physical address:

I am a Family Resident at the following Recovey Residence operated by Empowering Potential Housing (PLACE AN X IN CORRECT HOUSE):

Text field FEMALE 7089 Benson Ave, San Diego CA  92114

Text fieldFEMALE 1755 Eldon Ct, El Cajon CA  92021

Text fieldMALE 3507 Valley Vista Rd., Bonita CA  91902

Text fieldMALE 6328 Tooley St, San Diego CA  92114

Text fieldCo-Ed 3474 Angwin Drive, San Diego CA 92123

Text fieldMALE 1613 Watwood Rd, Lemon Grove, CA  91945

ONLY UPS, FedEx, food deliveries etc. to home – any mail sent to the home is returned to sender

Empowering Potential pays for a PO Box for you:

7107 Broadway Road #233, Lemon Grove CA  91945

(also location for checks to EPH - bed fee is $1000 per month)

Signature

Date

Signature

House Leader/Asst House Leader Signature 

Full name - Text field

Empowering Potential Housing

619-500-3987