apply. | One80

Dear Applicant,

One80 Inc. is a ministry resource to those with life controlling problems. In TN and VA our jails and rehabilitation centers seem to have revolving doors. The current rate of return is approximately 75% to 90%. One80 Inc. is seeking to change these statistics.

One80, Inc. is a Christ-centered re-entry program established to help men that are in recovery and/or have been recently incarcerated transform their lives through spiritual development, job training, counseling, sober living, and life-skills development. All participants must agree to comply with the following structure and guidelines to officially enter the One80, Inc. program. Failure to comply with this contract after signing can result in disciplinary action, including dismissal from the program.

Candidates for admission must thoroughly complete this application online or mail to One80 Inc.

Candidates are not accepted for admission until after completion of a face-to-face or phone interview with a One80 Inc. staff member. Those who provide false or misleading information may be denied admission.

Requirements for admission: Candidates for admission to One80 Inc. Must:

Be male requesting admission himself, admitting their addiction/life controlling problem, and sincerely willing to change.
Agree to abide by all guidelines, fully participate in all aspects of the Christian program, and refrain from any activity that the staff deems contrary to recovery or Christian growth. Violation of the guidelines may result in disciplinary measures and possible dismissal.
Be fully detoxified and 72 hours away from their last use of drugs or alcohol of any kind.
Be willing and able to commit to an uninterrupted 52-week program.
Be physically able to perform work assignments for job placement apprenticeship.
Be medically able to fully participate in the program. One80 Inc. is not a medical facility. We do not provide medical assistance or provide you with prescriptions. We do allow you to get needed medical and mental health care.
Be willing to refrain from the pursuit of romantic relationships other than with a legally married spouse while in the program.

First name

Last name

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

City

Zip / Postal code

Phone:

Emergency Contact Name and Relationship:

Emergency Contact Phone:

Do you have a valid drivers license?

Have you ever been to a rehabilitation or drug treatment center?

If so, where and when?

Marital Status:

Number of Children:

Do you have any contact?

Is there a no contact order?

Did you graduate from High School?

Do you have a GED?

Any college or trade school?

Occupational Experience:

Years Worked:

Special Skills:

Last steady job and how long:

Have you been fired or quit due to addiction?

Number of jobs held in last 5 years:

Are you a Veteran?

Branch of service and time in service:

Date and type of discharge:

If other than Honorable, explain:

If you are presently incarcerated, what are you serving time for?

Have you been sentenced?

By whom and length of sentence:

County/State:

How long have you served on this charge?

Number of times incarcerated:

Total incarceration time:

Do you have outstanding writs/warrants elsewhere?

Where?

What for?

Once your jail time is served will you be on parole, probation, or house arrest?

Name and phone of your attorney, public defender, parole, or probation officer:

List any court cases pending:

Have you ever been convicted/charged with child molestation?

Have you ever been convicted/charged with sexual abuse?

Have you ever been convicted/charged with a violent crime?

How is your present health?

List all major illnesses or operations and approximate dates:

Have you ever had a mental health diagnosis? Date?

List medications you are NOW taking and how long you have taken them:

How do you pay for medications?

Have you ever been in a recovery program? Date? Where? Explain:

Drinking History: Are you an alcoholic, what do you drink, how much, when do you drink, what type of drinker are you?

When did you take your first drink, first time drunk?

Is there a drinking history in your family? If so, who?

How long since your last drink?

Why do you want to stop drinking?

Drug History: What drugs have you used, how much, when do you use, cost per day?

How old were you when you started doing drugs, what is the first drug you did, and why did you first use drugs?

Is there a drug history in your family? If so, who?

What serious health problems has drugs cost you?

What accidents has drugs caused you?

Have you ever been hopitalized for substance abuse? When, where, and how long?

How long since you last used? Explain:

Why do you want to stop doing drugs?

Religious Background: Did you attend church as a child? Age started? Age quit?

What church/denomination where you raised in?

Have you made a commitment to Jesus as your Lord and Savior? When? Explain:

Do you agree to comply with all the requirements for admission as listed above?

Are you able to and do you commit to a 52-week uninterrupted program with One80 Inc.?

If applicable, have you obtained written permission from any legal supervision you may have (Child Support, Probation, Court Dates, Etc.) granting you permission for an unhindered 52-week program?

Do you commit to fully participate in all activities of this Bible based Christian program and refrain from activities staff deems contrary to recovery and Christian growth?

Do you commit to refrain from the pursuit of romantic relationships other than with your legally married spouse while in the program?

Are you physically and mentally able to fully participate in all aspects of the program including work assignments?

Did you personally complete this application?

Use this area to describe your religious journey beginning at the point you remember first being aware of your need for God.

As part of our learning the degree of commitment you would bring to the program, please answer the following question: Why should you be given the opportunity to participate in the One80 Inc. program?