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70x7 Housing Application
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Applicant Name
*
First
Last
did Recovery Current
Mobile Phone
*
Email Address
Preferred Contact Method
*
Call
Text
Email
Current Living Situation
*
Tell us briefly where you are staying now and why you are seeking housing.
Are you currently employed?
*
Yes, full time
Yes, part time
No, but looking for work
No, not currently seeking work
Approximate Monthly Income
*
Include all sources (employment, benefits, etc.).
Primary Source of Income
*
Are you a Veteran?
*
Yes
No
Are you currently justice involved (on probation or parole)?
*
Yes
No
Recovery & Support
*
Please share anything you would like us to know about your recovery journey, treatment, or support programs you are involved in.
Preferred Move-In Date
Preferred Housing Type
Select an option
Men’s housing
Women’s housing
Co-ed (if available)
No preference
Emergency Contact Name
*
Emergency Contact Phone
*
How did you hear about 70x7 Housing Foundation?
House Rules Agreement
*
I have reviewed the 70x7 Housing Foundation House Rules and agree to follow them if accepted into housing.
Drug & Alcohol-Free Agreement
*
I understand all 70x7 homes are drug and alcohol free, and I agree to live drug and alcohol free (including THC/CBD and medical marijuana).
Submit Application