Housing Application

To be accepted into SHIP Housing an applicant must complete all questions in this application and be interviewed by the SHIP staff. Phone interviews can be arranged if needed.

Carefully read the application and honestly answer the questions.  SHIP provides separate facilities for Men and Women.  Safe and Sober Housing is a step down program that does not have a predetermined length of stay - how long you stay depends on you, your needs, and your source of funding.

Is this a duplicate application?*
Would you like to schedule a phone interview?
Type of Housing*
Special Programs
When do you need housing?*
When will you need housing?
Name:*
Phone:
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E-mail:
Marital Status
Date of Birth*
Address:*
Have you used any other names or aliases?*
Please list any/all names you have used in the past
Are you employed?*
What do you expect your income to be next month?*
Who is your employer?
How many hours per week do you work?
Each member of the house is required to pay their share of the housing expenses. What is your source of income? (please list)
If you are not currently employed, you are required to participate in SHIP's Work Skills Program. Reasonable accommodations will be made for persons with disabilities.
SHIP Houses are Recovery Homes and require that residents be in recovery from alcohol or substance abuse, please indicate the type of program you are participating in to work on your recovery.*
Are you an alcoholic? *
Date of your last drink?
Are you a drug addict?*
Date of your last drug use?
Are you currently drinking alcohol and/or using addictive drugs?*
What is your sobriety birth date?
Are you under the supervision of the Idaho Department of Corrections?*
What is your IDOC number?
IDOC Facility?
Your case manager's name?
Your case manager's phone number?
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Will you be topping your time?
Your tentative parole date?
Please indicate which, if any, of the following you are involved with:
If you are involved in any of the above, who do you report to?
Do you have any felony convictions?*
Please list all felony convictions
Have you been convicted of drug manufacturing or distribution?*
Have you been convicted of any violent crimes?*
Please Explain
Are you a sex offender?*
Are you required to register?
Explain
Reference 1*
Phone1:*
-
Reference 2*
Phone2:*
-
Reference 3*
Phone3:*
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