Recovery Services & Housing

For those who have gone before us.

DarJune's mission is to build a bridge between addiction services by utilizing a recovery centered philosophy while providing a safe environment to live & recover.

Contact

Apply for sober housing services here.

Housing Application

First name

Birthday

Sobriety Date

Phone

Last Treatment/Halfway House

In how many years?

Last name

DOB

Last Home Address

Social Security Number

Number of treatment programs

What is the longest time period you have been clean and sober?

What was the reason for your relapse?

Sponsor/Mentor's Name & Phone Number

Counselor’s Name & Phone Number

Drug of choice

If yes, Name & Phone Number of Officer

If yes, what services are you receiving?

Name & Phone Number of Service

Current Employer

Name & Phone Number of Supervisor

Relationship Status

Single

Married

Longterm Relationship

Dependants

Yes

Number of dependants

Where do your dependent children live?

Does addiction run in your family?

Yes

Who in your family has addiction problems?

How many of those family members are in recovery?

Do any of your family members participate in support groups (Al-Anon/Teen)

What kind of support system do you have in place?

Would you have a safe housing option if DarJune Foundation, Inc., Sober Living House did not have a spot open? If so where?

Other pertinent information you feel is necessary for us to know:

Personal Reference #1 Name & Phone Number

Personal Reference #2 Name & Phone Number

By checking this box, I understand that the information given is accurate and true. Also, I give consent to contact any person(s) whose names are provided to gain information regarding my application.

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A specialist will be in touch with you soon!

DarJune Foundation INC

Recovery Services & Housing

For those who have gone before us.

Apply for sober housing services here.

Housing Application