Scholarship Application

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Name:*

Date*

DOB:*

Phone*

Email*

Current Address:*

City:*

State:*

ZIp:*

What Is Your Current Living Situation:*

Recovery Date:*

Primary Substances Used In The Past?*

Drug Of Choice:*

Why Do You Want To Come To Stride Sober Living?*

Do You Currently Have Any Outstanding Legal Issues? Please Include Warrants And Any Past/current/pending Charges And Upcoming Court Dates, Etc…*

Have You Ever Lived In A Recovery House Or Sober Living Home Before? (When and Where)*

Are You Currently Working? (Where/since When)?*

Current Monthly Income Amount?*

Current Monthly Family Income Amount (If Under 25 Years Of Age)?*

Is There Any Reason That You Cannot Be Employed?*

Have You Received Any Scholarship Funds In The Last 24 Months? If Yes, Please Describe?*

What Have You Done To Attempt To Acquire Funds For Sober Living?*

How Would A Scholarship To Stride Sober Living Benefit You?*

What Is The Best Thing That Has Happened In Your Recovery Process?*

Is There Anything Else That You Would Like To Share?*

Signature*