Agape Life Gardens Discipleship Home Application
Read Before filling out the application:
Application Process:
1) Complete online application and submit
2) Complete a phone interview with the program Director
3) Provide a letter of recomendation from your Pastor, mentor, or counselor
4) Complete a 1,000 word that includes why you want to be at the Agape Life Gardens Discipleship home, what you hope to accomplish during your stay, a 3-month/6-month/1-year goal list, and some of your tesimony.
5) There is a $200.00 non-refundable application fee that covers the inital costs of entry (drug test, background check, admin fees, discipleship material)
6) Upon arrival you must have two weeks rent for entry.
7) Before acceptance into the program, you must have a second interview to read over the rules and regulations. Once read you will have to sign that you understand and make a commitment to follow the discipleship home rules and regulations.
Our Christian discipleship homes are for individuals 18 or older with at least three months of sobriety. Acceptance into the discipleship program will require that you have graduated a three month drug and alcohol rehabilitation program, or three months of sobriety with a letter of recomendation from a pastor, counselor, or christian mentor that will vouch for you. We are a Christian Discipleship program where Jesus Christ is the Chief Cornerstone of our faith. This One Year Discipleship program is here to help you continue to build upon your spiritual house through intensive mentorship and Christian discipleship.
Important Disclaimer: We do not accept individuals that have been convicted of Arson or any type of Sexual Crimes.
Welcome to the Discipleship Home Application wizard
Click next to begin!
General
Tell us about yourself
What is your first name?
Client first name
What is your middle name? No middle name? Move on to the next question.
Client middle name
What is your last name?
Client last name
When is your birthdate?
Client birthdate
What is your race/ethnicity?
Client race
What is your gender?
Checkboxes
What is your marital status?
Client marital status
Are you a veteran?
Client veteran
Do you have a Drivers License?
Checkboxes
Drivers License #?
Number field
State Driver's License Issued in?
Text field
Do you own a vehicle?
Checkboxes
Vehicle make and model?
Text field
Vehicle license tag number?
Text field
Do you have vehicle insurance?
Checkboxes
Who is your insurance provider?
Text field
You must have a valid driver's license and insurance to drive while at Agape Life Gardens.
Medical History
Tell us about your medical history.
When was your last relapse date?
Recovery history 1 relapse date
What is your substance(s) of choice? Add multiple by clicking in the box and selecting different options
Client substances of choice
Have you been clinically diagnosed with anything? Add multiple by clicking in the box and selecting different options
Client diagnosis
Do you have any health problems? Add multiple by clicking in the box and selecting different options
Client health problems
What kind of meetings do you attend? Add multiple by clicking in the box and selecting different options
Client kinds of meetings attended
What allergies do you have? No allergies? Move on to the next question.
Have you had any of the following tests?
Medical Tests
If your answer is yes, please explain what legal issues your are involved with.
If your answer is yes, please list the county and contact information for your probation/parole officer.
The Agape Discipleship Home is a sober living home which requires expulsion without prior notice or refund of fees of any member who is found to be:
2. In possession of alcohol or drugs
3. Using any form of nicotine products (cigarettes, vapes, gums, patches, etc...)
4. Stealing of any kind from residents, staff, or the Agape homes
5. Engaging in violent behavior physically or verbally
6. Engaging repeatedly in disruptive behavior.
7. In default of weekly membership fee payments
All members of the Agape Life Gardens discipleship homes are members of a sober living home. You do not have renter's rights of tenants pursuant to the Alabama Propery Code, and expressly waive any such rights in exchange for membership privileges. By signing below you state that you have read the above notice and understand that you are applying for membership at the Agape Life Gardens Discipleship Program. Also by signing you agree to abide by the responsibilities and commitments of the house and fully subjedt myself to the rules of the program.
By signing below, you certify that the information contained in this application is true and accurate.