SOS House Application

Vision

A community of hospitality and healing for women survivors of trauma and addiction

Sisters of Solace

Sisters of Solace is a ministry that offers hospitality and a sacred space for women to heal from trauma and addiction. The model for our community is very simple. We’re here to offer compassion while you heal, empower you to take responsibility for your future and help you remain employed so you can stand on your own.

We also recognize that simple doesn’t mean easy. Healing takes time, intentionality and hard work. Sisters in our home get as much out of their stay with us at they’re willing to put in.

In our home you can expect support and guidance as you set goals and chart a course for achieving them. Our Advocates can help you remove barriers on your journey and gain access to services that can move your forward.

We do not have a standard program to follow, but rather, we intend to build relationships, understand your story and care for you deeply on your personal journey to healing. This means that your path will be unique for you.

We also take the community element of our home seriously and we have high standards for each sister to contribute and pursue healthy positive relationships with each other and our team. We know you’ve been through a lot but we believe in the importance of taking an active role in a peaceful and respectful environment.

Before you apply, please consider if you’re willing and able to put in the hard work and assume personal responsibility as we help you heal, become empowered and remain employed.

A final word . . . addiction recovery is mission critical for the healing of all the sisters in our home. For that reason, we have no tolerance for drug or alcohol use once you enter our home. We extend much patience and grace, but please be aware that a positive drug or alcohol screening will immediately end a stay at the SOS House.

Application

Date(Required)

MM slash DD slash YYYY

Name(Required)

First

Phone(Required)

Date of Birth

MM slash DD slash YYYY

Ethnicity(Required)

Primary Language(Required)

Gender(Required)

Male

Female

Marital Status(Required)

Military Status(Required)

None

Active

Veteran

Education/Employment

Highest Level of Education(Required)

Voactional or Job Training(Required)

Employment History

Current Employer(Required)

Job Title(Required)

Current Schedule(Required)

Supervisor Name(Required)

Supervisor Phone(Required)

Previous Employment

What form(s) of transportation do you use?(Required)

Do you have a current resume?(Required)

Yes

Upload Resume

Max. file size: 50 MB.

What forms of identification do you have?(Required)

Social Security Card

State ID

Birth Certificate

Driver's License

Check all that apply

What services are you currently receiving from local agencies?(Required)

Who referred you to Sisters of Solace?(Required)

Are you completing this application yourself?(Required)

Yes

Check all that apply

Victim of prostitution, sex-trafficking

Victim of domestic violence

History of child abuse

Fear of current partner

Immediate danger

Currently incarcerated

Outstanding warrants for arrest

Drug or alcohol abuse

Drug court

Sexual assault charges

History of inflicting violence

Smoke or vape

Upcoming court dates?

Currently on probation or parole

Stayed at other residential facilities

Any Clean Time?

Upcoming Court Dates

Probation or Parole Office name

Residential Facility stayed at

Physical Health

What physical diagnoses do you have?(Required)

What physical limitations do you have?(Required)

Do you require any physical assistance?(Required)

What medications are you taking?(Required)

Who is your primary care provider?(Required)

Are you on Disability?

Yes

Do you have Insurance?

Yes

Provider(Required)

Policy Number(Required)

Do you have Medicaid?

Yes

Medicaid Number(Required)

Do you have your Medicaid card?

Yes

Mental Health

What mental health diagnoses do you have?(Required)

Do you have a history of any of the following?(Required)

Suicide

Self-Harm

Harm to others

No history

Have you received counseling?(Required)

Yes

Where?(Required)

Have you participated in substance abuse recovery or 12 step programs?(Required)

Yes

Tell us your experience(Required)

Personal Contacts

Do you have children?(Required)

Yes

Who has custody?(Required)

Where are they currently living?(Required)

Do you have visitation rights?(Required)

Yes

Describe your visitation schedule?(Required)

Do you pay or receive child support?(Required)

Yes

Describe(Required)

Tell us more about your children:(Required)

Supportive Contacts

Name(Required)

Phone(Required)

Relationship(Required)

Name(Required)

Phone(Required)

Relationship(Required)

Name(Required)

Phone(Required)

Relationship(Required)

Do you have a relationship with a significant other?(Required)

Yes

Describe(Required)

Family History

Describe your relationship with your parents. Do they live in the area?(Required)

What other family members are involved in your life? Do they live in the area?(Required)

Describe any history of abuse in your family(Required)

Describe any substance abuse in your family(Required)

How can Sisters of Solace help you?(Required)

Describe your vision for your future:(Required)

What might be standing in the way of your goals?(Required)

How do you feel about advancing your education?(Required)

What kind of work would interest you?(Required)

Are there any loose ends in your life you need to tie up before coming to our home? (Examples: storing personal belongings, putting affairs in order to leave abuser, placing children in a safe environment, discarding old cell phone if necessary, initiate restraining order process, etc.)(Required)

Do you have scheduled obligations or commitments that you will need to keep? Please list days and times of those commitments(Required)

What date could you be available to move in?(Required)

Tell Us About:

Greatest Dream:(Required)

Greatest Fear(Required)

How well you get along with others:(Required)

Your communication style:(Required)

What gets on your nerves?(Required)

What does respect mean to you?(Required)

How can you show that to others?(Required)

What makes you feel respected?(Required)

What other things do you want us to know?(Required)

CAPTCHA

This field is for validation purposes and should be left unchanged.

Application Process

Step 1

Complete the application above

Step 2

Call SOS House every day to confirm your status as ACTIVE on our waitlist.
You can leave a message including your name and the best way to contact you.
816.259.2316

SOS House Application

Sisters of Solace

Application

Education/Employment

Employment History

Physical Health

Mental Health

Personal Contacts

Supportive Contacts

Family History

Tell Us About:

Application Process

Step 1

Complete the application above

Step 2

Call SOS House every day to confirm your status as ACTIVE on our waitlist.
You can leave a message including your name and the best way to contact you.
816.259.2316

Step 3

When there is an opening at the SOS House, we will contact applicants on the
waitlist to schedule an interview.

Step 4

Our team will review qualified applicants

Step 5

Our Case Manager will contact approved applicants to discuss admission process

SOS House Application

Sisters of Solace

Application

Education/Employment

Employment History

Physical Health

Mental Health

Personal Contacts

Supportive Contacts

Family History

Tell Us About:

Application Process

Step 1

Complete the application above

Step 2

Call SOS House every day to confirm your status as ACTIVE on our waitlist. You can leave a message including your name and the best way to contact you. 816.259.2316

Step 3

When there is an opening at the SOS House, we will contact applicants on the waitlist to schedule an interview.

Step 4

Our team will review qualified applicants

Step 5

Our Case Manager will contact approved applicants to discuss admission process

Call SOS House every day to confirm your status as ACTIVE on our waitlist.
You can leave a message including your name and the best way to contact you.
816.259.2316

When there is an opening at the SOS House, we will contact applicants on the
waitlist to schedule an interview.