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. Â SHIP provides separate facilities for Men and Women. Â 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?*YesNoWould you like to schedule a phone interview?Yes PleaseType of Housing*House for MenHouse for WomenSpecial ProgramsHomelessVeteransWhen do you need housing?*ImmediatelyLaterWhen will you need housing?Name:* First Last Phone: Area Code - Phone Number E-mail:Marital StatusSelect valueMarriedNever MarriedSeparatedDivorcedDate of Birth*Address:* Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip CodeHave you used any other names or aliases?*YesNoPlease list any/all names you have used in the pastAre you employed?*YesNoWhat 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.I agree to participateSHIP 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.*Detox/Allumbaugh House Residential TreatmentOutpatient Treatment12 Step ProgramotherAre you an alcoholic? *YesNoDate of your last drink?Are you a drug addict?*YesNoDate of your last drug use?Are you currently drinking alcohol and/or using addictive drugs?*YesNoWhat is your sobriety birth date?Are you under the supervision of the Idaho Department of Corrections?*YesNoWhat is your IDOC number?IDOC Facility?Your case manager's name?Your case manager's phone number? Area Code - Phone Number Will you be topping your time?YesNoYour tentative parole date?Please indicate which, if any, of the following you are involved with:ProbationParoleCourt Ordered to TxDrug CourtMental Health CourtIf you are involved in any of the above, who do you report to?Do you have any felony convictions?*YesNoPlease list all felony convictionsHave you been convicted of drug manufacturing or distribution?*YesNoHave you been convicted of any violent crimes?*YesNoPlease ExplainAre you a sex offender?*YesNoAre you required to register?YesNoExplainReference 1* First Last Phone1:* Area Code - Phone Number Reference 2* First Last Phone2:* Area Code - Phone Number Reference 3* First Last Phone3:* Area Code - Phone Number Submit ApplicationReset