Abbreviated Admissions Application
Dear Friend,
Thank you for your interest in the Reformers Unanimous School of Discipleship. Our homes are located in Rockford, IL and are the only residential treatment facilities officially sanctioned by Reformers Unanimous International. There are many others who have attempted to duplicate what we do, but we are the only program that offers the RU residential program as it was originally designed and crafted by ministry founder, Steven Curington. We are very excited that you are considering us in your journey to recovery over your stubborn habit or addiction.

Our mission is to train and empower men and women to live victorious Christian lives, enabling them to have permanent victory from any and all crippling addictions. It takes most students aproximately six months in our program to bring about these changes. If you are serious about and committed to your recovery, we are certain that we can help you!
To get started, please fill out the application below and submit it to our admissions staff. A friendly staff representative will receive your application, review it, and contact you as soon as possible to discuss what’s necessary to become part of our program, including the program fees required and the rules and regulations you must abide by while in the program.

Name
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Street Address
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City and State
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Zip
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Phone Number
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Email Address
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Age
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Sex
Marital Status
Do you have any medical conditions that may present a problem? If yes, please explain.
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Do you have any legal circumstances that may present a problem? If yes, please explain. *
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What is the best time to contact you? *
Your answer
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