This application for Transitional Housing Enterprises is in four parts and includes a program agreement. Each part of the application must be filled out completely. Your application may be under review for an undetermined period before you get a final answer.

I. Biography

Emergency Contact

Spouse

Spouse Phone #

Education ( Highest Obtained)

Emergency Contact Phone #

Emergency Contact Relationship

TDCJ Education/Certifications

Children/Ages

If you do not have funds, who can assist you with your program fees? (Name & Phone #)

Outside Work Experience

Describe your childhood and relationship with your spouse and/or children

II. Incarceration History

Current Offense & Describe Circumstances in Detail

Term of Sentence

Term Served

Date of Next Parole Hearing : If paroled, use today's date

Earliest Expected Release Date : If already released, use today's date

List additional offenses, sentences, and time served you have received and describe the circumstances surrounding EACH offense. Are you a registered sex offender and if so, did it involve a minor? WE ARE UNABLE TO ACCEPT SEX OFFENDERS

How do you view your offense?

III. Personal Development, Motivation, and Life Goals

What specific steps have you personally taken while incarcerated to help ensure you will not return to prison ( including courses you have taken)

Why do you want to reside at Transitional Housing Enterprises?

What are your goals?

IV. Medical History

Have you ever received SSI/Disability from the Government? If so, for what?

Have you/will you receive VA benefits from the Military? If so, for what?

Are you under continued medical care for any chronic physical illness/disability? If so, please explain the conditions and limitations

Have you been or are currently under the care of psych social services? If so, please explain the conditions and limitations

Do you currently take any medications? If so, please list

Please elaborate about your addiction

Your medical history is important for us to understand the care and attention that is needed while you are a resident at Transitional Housing Enterprises. Your medical condition is kept confidential and is used only for obtaining the proper care necessary while here. Medical/MHMR conditions DO NOT automatically disqualify you from acceptance to Transitional Housing Enterprises.

Transitional Housing Enterprises is a residential transition program operated under and emphasizing Christian principles. Our mission is to offer a safe, sober, wholesome environment in which men can learn to love and care for each other, serve one another and the community, and commit to restoring their lives and relationships with family, friends, and their community.

Upon arrival, we will assist residents with obtaining clothing, social services, and securing employment. In return, we expect residents to abide by the House Rules in the attached Program Agreement. Your signature will be required in the Program Agreement as well as any other rules and regulations that may be required upon assistance.

If you are in the United States, from another country, and you do not have in your possession a stamped Social Security Card with an Employment Authorization Card or a Green Card, we will not be able to accept you into Transitional Housing Enterprises.

Upon acceptance as a resident of Transitional Housing Enterprises, I agree to place myself under the authority and leadership of the Board of Directors and staff. As such, I agree to abide by all the rules and regulations of the Program Agreement and to submit to those in authority over me.

I agree to the terms & conditions

Your Signature

Thanks for submitting! We will get back to you shortly!