My House Ministry Resident Application
Thank you for taking a moment to complete this initial application. Once completed and reviewed, our Operations Manager will be in touch to schedule an interview.
First Name *
Your answer
Last Name *
Your answer
Phone Number *
Your answer
Referral Organization
Your answer
Secure Income
My House Ministry residents must be currently employed or have consistent monthly income in order to pay the weekly program fee. The weekly program fee is $130. ($20 is reserved for your savings account). The SSI payment is $542.90 due the third of each month. ($86.60 is reserved for your savings account).
Income Source *
Drug Use (Illegal & Recreational)
Drug and alcohol use is prohibited in the My House Ministry program. Drug screenings will be conducted prior to move in and at random while residents are in the program.
Are you currently using drugs (other than prescription medication)? *
What types of drugs?
Your answer
My House Ministry accepts applicants with children.
Girls (ages 0-18), Boys (ages 0-10) at the time of admittance into the program.
Childcare must be organized by the applicant prior to acceptance into the program.
Do you have children? *
Do you have childcare?
List Age and Gender of Children
Your answer
Romantic Relationships
Romantic relationships are not permitted in the My House Ministry program for the safety of other residents, as well as, the beneficial outcome of the applicant.
By checking this box, you understand this policy *
Additional Information
Please feel free to share any other information you think might be helpful for your application to My House Ministry.
Your answer
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