SG Living LLC
APPLICATION FORM

Personal Information:
Full Name: Client first nameClient last name

Date of Birth:Client birthdate

Phone Number: Client phone

Email Address: Client email

Current Address: Client Address

Background Information:
Are you currently in Recovery (yes/no): Text field

Have you previously resided in a sober living environment? (Yes/No): Text field

*If yes, please provide details: Text field

Are you committed to attending recovery-based support groups (e.g., AA, NA, SMART Recovery)? : Text field

Have you ever been convicted of a felony? (Yes/No): Text field

*If yes, please provide details: Text field

Are you currently on any prescribed medications? (Yes/No): Text field

*If yes, please provide details: Text field

Do you have any allergies? (Yes/No): Text field

*If yes, please provide details: Text field

 

References:
Please provide two references (personal or professional):

REFERENCE 1:

Name: Text field

Relationship: Text field

Contact Information: Text field

REFERENCE 2:

Name: Text field

Relationship: Text field

Contact Information: Text field

 

Acknowledgement and Agreement:
Zero tolerance for aggressive behavior, verbal, or physical.

Zero tolerance for theft.

Agree to participate in random drug and alcohol breathalyzers, screenings and testing. Failure of one of these screenings will result in immediate removal from home.

If guest/tenant violates any of the agreed upon terms, there will be immediate removal from the home without further notice requirements from landlord.

Monthly housing fee is the sole responsibility of guest/tenant, if guest/tenant is on a program that supplies funds for housing it is the responsibility of the guest to set up and maintain the program requirements. If failure to pay occurs through the program, the responsibility is the guest/tenant to pay monthly housing expenses. Failure to pay fees will result in immediate removal from the home.

By typing my full name and date below, I confirm that all the information provided in this application is accurate and complete. I agree to adhere to the rules and policies of SG Living LLC. I understand that falsification of any information may result in denial of my application or termination of my tenancy.

Print Name: Client first nameClient last name

Signature: Signature

 

Personal Commitments and Understanding:
 

Please acknowledge the following by writing "I accept all" in the space provided below.

I will adhere to all house rules and policies, including curfews and meeting attendance. I understand this is a drug- and alcohol-free environment. I commit to participating in house activities, including daily chores, weekly meetings, and deep cleans. I agree to abide by the zero-tolerance policy on bringing substances onto the property. I understand that non-compliance with house rules may result in discharge from the program.

Text field