Future Survivors Application

Prospective Resident Assessment

Dear Prospective Resident,

Hello, please read through this page carefully. If you decide you want to enter our program, please fill out the interest form below. We will contact you shortly. 

An application form filled out, plus an interview, does not constitute automatic acceptance into the Rescue us Program. In addition to the interview process, please keep the following in mind. 

1. ALL pending legal matters such as court appearances or jail time MUST be disclosed to Rescue Us. 

2. If you’re on probation or parole, the court having jurisidiction over you must approve before your coming to us. 

3. Because Rescue us is NOT A MEDICAL FACILITY, any necessary detoxification must be done before admission. Also, if you are on anu prescribed medication that should have 2-3 months’ supply. 

4. There is no financial obligation. Keep in mind that we are not a federal or state facility. 

Thank for taking this step of faith. 

Rescue us Executive Director. 

Interest Form