"Better Living Through Sober Living"!

Current donations:  $21,530

Jeffrey’s House is a sober working environment that provides stabilization and a supportive sober atmosphere.

The general criteria for acceptance into Jeffrey’s House are:

  • Residents must be sober and actively maintaining sobriety by being involved in a recovery program.
  • Residents must have the ability to pay $125.00 dollars rent weekly. A $125.00 dollar non-refundable entry fee is required to reserve a bed. First and last weeks’ rent is required, therefore there is a total payment of $375.00 dollars to enter the house. IF A RESIDENT IS ASKED TO LEAVE, THERE ARE NO REFUNDS. If leaving is voluntary, you must give a one-week notice. During this one-week period payment of rent is not required since all residents have a one-week reserve that will be used to pay their rent.
  • Residents must have a willingness to cooperate with other residents and contribute to improving the house and community.

House Rules

  • Residents are expected to abstain from alcohol and other substances. If a resident is using alcohol/drugs or involved in any drug activity, they will be immediately discharged. In addition, residents must agree to submit to three (3) randomly scheduled drug test per week.
  • Sexual contact between residents is cause for immediate discharge.
  • Rent is due by Friday prior to leaving the House for the weekend. Non-payment of rent is subject to disciplinary action and may result in discharge.
  • Disruptive, threatening or abusive behavior to residents and/or staff will not be tolerated and subject to discharge.
  • Residents must agree to participate in a minimum of three (3) N/A or AA meetings per week.
  • Residents must agree to participate in three (3) urine screens per week.
  • Residents must attend one (1) in-house (Sunday) meeting weekly.
  • All residents must be in the house by: 11 pm. Sunday through Thursday; weekends by 12 Midnight.
  • New residents of Jeffrey’s House will not be permitted to have overnights for one month. Overnights are Friday or Saturday, but not both.
  • Residents must be willing to do assigned chores.

 

MY SIGNATURE INDICATES THAT I HAVE READ AND UNDERSTAND ALL OF THE AFOREMENTIONED, AND IF I AM ACCEPTED, I AGREE TO ABIDE BY ALL OF THE RULES AND RESPONSIBILITIES OF THE HOUSE OR BE SUBJECT TO DISCIPLINARY ACTION WHICH COULD RESULT IN IMMEDIATE DISCHARGE.    

Signature:

      Date:

 

Type or Print (clearly) All Information. Use additional sheet if necessary. Please read application CAREFULLY.
I hereby apply for residency into Jeffrey’s House, and I am providing the following information for use by Jeffrey’s House in determining my eligibility and appropriateness for residency.
Answer all questions that apply.
Full Name:

Current Address:

Telephone numbers: Home Work Cellular            
Date of birth: Social Security No.

Are you currently homeless/without a permanent place to live?


Marital Status: Health Insurance:
     
Therapist: Psychiatrist: Physician: Medical Condition:

Are you taking any prescription medications?

If yes, please list them:

Are you taking Benzodiazepines?

Drug of choice:

Have you been to rehab? 

If Yes, where?

Are you a recovering:
Your sobriety/recovery date:   
Do you attend AA or N/A meetings?


Employer:  

Do you have any outstanding warrants?
Have you ever been convicted of a sex crime?
Have you ever been convicted of arson?

Referral source: (If coming from an institution, which one?)

Release/Discharge Date:
(Referral source must be filled in, whether an institution or NOT.)

List name of parole or probation officer:

List names and telephone numbers of two individuals who may be contacted in the event of an emergency:
1.

2.



Jeffrey’s House is a sober environment and will not tolerate residents using alcohol/drugs. If a resident is found to be using either substance he will be immediately discharged.

Signature:   Date:

 

 

Consent Form

 
I, an applicant for Jeffrey’s House do hereby voluntarily consent to requests for urines and/or saliva specimen and agree to fully participate in the testing program.

If my specimen is found to be positive, I understand I will be immediately discharged from Jeffrey’s House.

Signature   Date:

 
I,  , have read the aforementioned consent information, rules, criteria and application provided by Jeffrey’s House and I understand that if I am accepted I agree to the following terms:

I waive any landlord/tenant rights with respect to residency at Jeffrey’s House. I understand and agree to comply with the rules and responsibility of the house.

In addition, I understand there will not be any money refunded if I am required to leave. If leaving is voluntary, I must give a one-week notice.

Signature  Date:  

 

 

 

 

 

 

 

 

 

 

 

Additional Rules

  1. N/A and A/A slips must be signed whenever attending meetings. They will be checked EVERY Sunday by the House Manager.
  2. Urine samples are randomly scheduled three (3) times per week.

*Please note: All must follow urine collector’s direction when completing a urine sample.

  1. Curfews are in effect at both houses. Specifically: 11 p.m. Sunday through                               Thursday and 12 Midnight on Friday and Saturday.

 

  1. Residents are allowed to have visitors: Saturday 12 Noon – 2:00 p.m.; and, Sunday 12 noon – 2:00 p.m. Please respect your visitors and other residents by understanding and remembering that this is a sober house, where we all live in harmony.
  2. No cooking after 10 p.m., and NO EATING IN BEDROOMS ANYTIME.
  3. Jeffrey’s House is not responsible for any lost belongings. All belongings must be picked up 7 days after a resident leaves (voluntarily/involuntarily) Jeffrey’s House. If belongings are not picked up during this period, after seven days, they will be donated.
  4. Smoking is done outside the house, in designated smoking areas. Smoking in the house will result in immediate discharge.
  5. No loitering in front of the house or driveway.
  6. The Landline house telephone can only be used in 15 minute intervals. Please be considerate and courteous of your housemates.
  1. Rooms should be neat, and must be cleaned daily.

 

 

PLEASE KEEP THIS FORM.