Name: Text field
Phone: Text field
Where are you Staying? Rocky Mountain Sober Living
How much are the Membership Dues? $150.00 Intake & $700.00 per month
If NO, what house(s) were you at?Text field
What were your dates of stay (MM/YY)? Text field
Other than sober living, what steps are you taking in your recovery? Text field
If yes, provide name and contact information,
Are you on Probation or Parole (choose one)?
If yes, provide the name and contact information of the Probation Officer:
In your own words, please provide us with a letter stating why you should receive funding.
All Letters Must Include
· What is your history of substance use?
· When did you start using?
· Why did you start using?
· Have you experienced any trauma or traumatic events?
· Any substance use treatment you have received.
· Any mental health treatment you have received.
· What do you want from your recovery?
· Provide three recovery goals.
· What will you do to further your recovery?
· What support system(s) do you have
· What coping skills are working for you?
Copy and Paste the list above on the space provided below. Make sure to cover every point asked. This is an opportunity for you to explore yourself.