ErieHousing.org

Application for the Sober Living Program

Please take a few moments to fill out this free, short application. Direct any questions to info@eriehousing.org.

Name * Required

Email Address * Required

Phone Number * Required

Gender * Required

Date of Birth * Required

We currently only house individuals. Do you need housing for children? * Required

Do you have a vehicle? * Required

We cannot accept any animals in the home. Do you have any service animals or pets? * Required

Please tell us a little bit about yourself and your situation * Required

Feel free to add any additional information you feel is relevant to your admission into the Erie Housing Independent Shared Living program.

Are you okay with a shared bedroom? There are no bunk beds. * Required

This is a community living situation in a home with multiple people. We don't have individual apartments. Are you okay living in a group situation? * Required

Do you have a case manager or parole officer or an individual who is in charge of your treatment?

Please add the contact details for any agency personnel, case managers, or social workers you regularly work * Required

If none, write "None"

This is a program, not a lease. You could be removed immediately for breaking the rules of the house or causing disturbances. Please acknowledge that you understand this. * Required

All of our houses are sober living homes. Alcohol, marijuana, and illegal substances are not allowed on the property, and anyone caught with them will be immediately removed. Please acknowledge that you understand this. * Required

Please identify any funding sources which will be used to pay for your housing expenses. This could be a job, SSI, SSDI or any other income source. * Required

What is your monthly income after taxes ("take home pay")? * Required

Have you ever been convicted of a felony? * Required

Are you currently pending any criminal legal action? * Required

If yes to either, please provide a list of charges below, including the nature of the incidents and legal outcomes:

Are you currently listed in any Registered Sex Offender databases which might affect your residence options? * Required

I affirm that all information provided in this document is true and correct as of the date on which this document was completed. (PLEASE PRINT YOUR FULL NAME)

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