Preliminary Application Form

Code of Conduct

I understand and agree to the following and understand that later I will be asked to commit to a more full and complete list of house rules and to educational residential agreement as well as to fill out a more complete/intake for acceptance:

1. 1. To live drug and alcohol free, while in the HnH program, with the exceptions of medications prescribed to participants, not exceeding prescribed amount. We DO NOT ALLOW medically assisted treatments (MAT), such as Methadone, Suboxone or medical or recreational marijuana.
   2. Rooms may be searched, and toxicology screens may be conducted at any time. Violations associated with either are cause for dismissal, solely at the discretion of HnH.
   3. Daily chores, weekly house meetings, and monthly educational meetings are MANDATORY! Failure to comply is considered a violation and may result in dismissal.
   4. Complete a 60-day probationary period. No overnights are allowed for the first 30 days; after which one overnight may be granted for the remaining 30-day period. Upon completion of the 60-day probationary period, no more than 4 nonconsecutive overnights are allowed in a 30-day period. Prior permission from a staff person is required, no less than 1 week in advance, when planning to be gone overnight.
   5. All visitors must be pre-approved by the Peer Leader and are only allowed in common areas. No visitor will be allowed in a participant’s room. Visiting hours are only on weekends from 10:00 A.M. to 4:00 P.M. for no more than 4 hours. No visitors can be under the influence of drugs or alcohol while visiting.
   6. Physical violence (punching/kicking/pushing/biting, etc.), verbal abuse, harassment or any other kind of violence, theft, use or possession of firearms or weapons of any kind or lying to staff members are cause for immediate termination. This means respecting others as unique human beings and treating them as you would like to be treated.
   7. Whether on or off premises, illegal activity will be cause for immediate dismissal. These include but are not limited to using or distributing or possessing illegal drugs; theft; illegal gambling; prostitution.
   8. Monthly dues of $475.00 / $500.00 need to be paid by the 1st of every month and will be considered late if paid AFTER the 7th of each month, at which time is cause for termination from the program.
   9. As a program participant, I will complete an Educational and Behavioral Modification Plan developed by the HnH Educational Director, Peer Leader and I, which I agree to follow. Plan will include long-term and short-term goals and may include outside counseling, attending AA/NA meetings, etc. Each plan is independently developed for each participant.
   10. If dismissed from the program for any cause, Participant agrees to vacate the premises IMMEDIATELY without recourse.
   11. Stealing of any kind or damaging the property of either HnH or another participant in the program is cause for immediate dismissal.
   12. Smoking is not permitted within the premises, to include but not limited to room assignment and common areas. Additionally, these areas must be kept in neat and orderly condition.
   13. I understand that there is a campus wide “Quiet Time” and that loud music, television, and the running of washing machine, dryer, and dishwasher are not allowed between the hours of 11:00 P.M and 6:00 A.M. The Kitchen is closed between the hours of 7:00 P.M to 6:00 A.M unless special permission had been obtained from the house Peer Leader.

Once this preliminary application is received it will be reviewed and applicant contacted (through the email or phone number provided on this application) as to their status prior to any interview process which starts with filling out a full application.