To ensure that information is
as accurate and complete as possible, application must be filled out by the
applicant and not a parent, spouse, fiancé, brother or sister, or other family
member or friend.
If your not sure of an answer,
select the option that fits best.
Our mission is to help the chronic
substance abusing, chemically dependent, and/or compulsive pathological gambler
develop into what they are capable of becoming, and to ultimately develop a life
based upon truth, goodness, wholeness, justice and order, richness and totality,
and autonomy and self-sufficiency.
We accomplish our mission by providing innovative, comprehensive and
individualized educational services, in conjunction with a highly structured,
sober, and safe permanent supportive living environment. Hope for Tomorrow, Inc.
is committed to the belief that incorporating a holistic approach to substance
an accountable, responsible,
We provide professional clinical services to individuals regardless of race,
ethnicity, age, creed, sex, sexual orientation, HIV/AIDS status, or financial
ability to pay.
Any information provided and/or gathered, either with an answer or by not
answering a question is used strictly by Hope for Tomorrow, Inc. to determine
appropriateness for placement in certain programs and/or for a referral to other
programs and/or services. All information is confidential and will not be shared
with another person or agency unless a signed and dated release of information
is provided by you.
Please do not
print this form. Data is only accepted electronically.