MSRHW Application
Mid-Shore Restoring Hope In Women
12400 River Road
Ridgely, MD. 21660

1. You must fill out this form before we will make a decision on approval.

2. You must be approved by house Owner/Manager. Meeting their house requirements.

3. You must pass a drug screen, when entering the house. (If a positive drug screen comes back, you may lose your funding, it will be at the board's discretion)

4. You must arrive on the scheduled date given to MSRHW and house owner/manager. If date of arrival changes for any reason please contact us. This could cause a loss of funding, it will be at the board's discretion if funding will still be available for you.

In this event, please call us directly, (if after 5pm or a weekend leave a message).

5. It is at our boards discretion who we approve and do not approve.

6. Please remember we are a board of volunteers, while we understand that emergencies happen, our normal operating hours are 9am-5pm. If you reach out after 5pm, or on a weekend please allow us 24 hours or the next business day to get back in touch.

7. Please remember we may follow up with additional questions.

In order to be able to provide funding such as this, we rely on various fundraisers we host throughout the year. We are always in need of volunteers and helping hands. We ask you please volunteer at one of our events.

Completing our application, means you have read and agree to our terms. Once we have reviewed your application we will be back in contact within 48 hours (not including Saturday or Sunday). If it is an emergency issue please have your house manager reach out to one of our board members.

We wish you luck in your recovery!

Board Members:


Email address *
Today's Date *
First and Last Name *
Contact Number *
Date of Birth *
County you live/lived in *
Who referred you to us? *
Which Recovery House are you going to? *
Expected date of arrival? *
Are you coming from: *
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