STANDARD - VSL - Transparent

Vanderburgh Sober Living
(844) 762-3747
www.vanderburghhouse.com

💜 Vanderburgh Sober Living^TM is a network of

independently operated recovery homes organized

and supported by The Vanderburgh Foundation, Inc.,
a registered 501(c)3 Charitable Foundation.

📋 Guest Application

Vanderburgh Sober Living welcomes applicants looking to continue their recovery journey! We carefully screen each applicant to ensure a good fit in a VSL recovery home. Our Guest Handbook can be accessed through this link.

Please provide all information to the best of your ability; we cannot process incomplete applications. False information given on this application is grounds for rejection of the application.

If you would like an update on an application you have already submitted or to apply over the phone, please call us at (844) 762-3747. You can also apply with a paper application: download here.

General Information

First name*

Last name*

Date of birth*

Month/Day/Year

Preferred language

Idioma preferido

Primary contact number*

Applicant's number?*

Is this the applicant's phone number or a number for someone else?

Gender*

Who is filling out this application?*

Applicant

Other (such as caseworker, aftercare, etc.)

Have you ever lived in one of our homes, or have you applied in the past?*

Yes

Desired move-in timeline*

What is your current address?

Please provide your current legal address here. Include the number (apartment # if applicable), street, city state, and zip code. Please note: this may not be the address where you currently live.

If you do not have a permanent or legal address, then please indicate this here.

Desired Location

Desired state*

If you are applying for a specific VSL home, please provide that information here.

It is also important that you note the home in the field below if you know which one you would like already. A list of the available homes can be found here.

Recovery Background

Legal History/Criminal Background

Have you been convicted of any felonies?*

Yes

Have you ever been found guilty of a sexual offense?*

Yes

Have you ever been convicted of arson?*

Yes

Are you currently on probation?*

Yes

Are you currently on parole?*

Yes

Treatment History

Have you ever been in residential treatment?

Yes

If you are being released from a treatment program, please select from this list. If not, please skip ahead to “Financial Information”.

Were you in another program previously?

Please select the type of program you last attended

If you are awaiting a release from jail or graduation from a program, please tell us what that expected date is.

Month/Day/Year

Financial Information

Please describe any and all sources of income which you will use to pay rent*

Additional Information

Please tell us anything that would be helpful for us to know when contacting you.
You might want to note what phone number or email address (personal or caseworker) is the best means of contact.

Terms and Conditions

I hereby authorize VSL and its designated agents to conduct a review of my background including income, housing, treatment, criminal history, or any other public records. I authorize any individual, company, or public agency to release any information, verbal or written, pertaining to me, to VSL or its agents. By submitting this application I am agreeing to the VSL Privacy Policy.*

Agreed by:*

VSL homes are NARR Level II Recovery Residences and are not clinically monitored or clinical programs and do not offer case management. We do not require bio-psych-social assessments or medical documentation. All information necessary for acceptance will be collected through the phone screen and directly with the Operator of the home.

Requests for Reasonable Accommodation: We consider all requests for reasonable accommodations to ensure that our guests can live comfortably and participate fully in our community. If you have a disability and require an accommodation, please inform the Intake Coordinator assigned to your application. We are here to support your recovery journey and will work with you to address your needs.