Application for Admission

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Anchor Point Community, LLC uses this Application for Admission to evaluate whether a prospective resident may be a good fit for APC's recovery residence program before move-in. Submission of an application does not guarantee admission. Admission decisions are based on program eligibility criteria, safety considerations, appropriateness for communal recovery housing, medication accountability needs, legal and safety-related disclosures, willingness to follow APC policies, and APC's non-clinical level of support.

APC may verify information provided in this application and may screen applicants through multiple public safety, registry, court, and background-related databases. APC does not accept applicants who are currently required to register as sex offenders or who appear on a sex offender registry.

Email *

Full Legal Name *

Preferred Name

Date of Birth *

YYYY

Which Location are you applying for? *

Men's Location (W 6th Ave.)

Women's Location (W 78th Cir.)

Phone *

Current Address or Current Living Situation *

Are you currently experiencing homelessness, in treatment, incarcerated, hospitalized, staying with family/friends, or in another housing program? *

Yes

If you answered yes to any of the above, please explain

Referral Source (How did you hear about us or who referred you?) *

Desired Move-In Date *

YYYY

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