APPLICATION 1. Are you currently in in-patient treatment for alcohol and/or drug abuse in the state of Utah? YesNo [group group12] Only individuals who are currently in in-patient treatment for alcohol and/or drug abuse in the state of Utah are eligible for the program. [/group] [group group1] 2. Are you willing to remain in Utah for sober living? YesNo [/group] [group group21] Only individuals who are willing to remain in Utah for sober living are eligible for the program. [/group] [group group2] 3. Are you a minimum of two weeks from your anticipated discharge date? YesNo [/group] [group group31] Only individuals who are a minimum of two weeks from your anticipated discharge date are eligible for the program. [/group] [group group3] 4. Do you not have the financial resources or medical insurance to pay for sober living? YesNo[/group] [group group41] Only individuals who do not have the financial resources or medical insurance to pay for sober living are eligible. [/group] [group group4] YOU ARE ELIGIBLE TO COMPLETE THE APPLICATION All scholarship recipients are reviewed throughout each month and decided on by the end of each calendar month. Please fill out the form below. Fields marked with an * are required Referral Source Name* Birthdate* Phone* Address* Email* [/group]
