Application

Horizon House Residency Application

To become a resident of Horizon House, you must complete this form, and someone will contact you to schedule an interview. Please answer all fields truthfully, as the questions will determine your eligibility.

Are You An Alcoholic

Are You Addicted To Drugs?

Do you attend NA/AA meetings?

Do You Want To Stop Drinking Alcohol/ Using Addictive Drugs?

Do You Currently Have a NA/AA Sponsor?

Are You Currently Employed?

Are You Receiving Welfare Or Any Other Non-job Related Income?

Do You Expect Your Monthly Income To Change In the Next 30 Days?

Are You Currently On Probation Or Parole?

Do you take any prescription drugs that were prescribed to you?

Have you ever been to a treatment facility for alcoholism or drug abuse?

Other Forms