Inquiry for Assistance and Programs

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Recovered Souls is proud to offer assistance and special programs to individuals actively working their recovery from substance addiction. Housing assistance is provided for transition from treatment to sober living, imminent employment to sustain living arrangements is required. Emergency housing assistance for unforeseen circumstances may also be approved.

Please complete and submit the form below, and a representative from Recovered Souls will review your request, contact referrals and contact you to discuss your interests and goals.

Email *

First Name *

Last Name *

Phone Number *

Date of Birth *

Are you a Massachusetts resident for 2 years (plus) *

Yes

Do you live in

Quincy

Weymouth

Other:

Clear selection

Street Address *

City *

State and Zip Code *

Which program or services are you interested in? *

HiSet/GED Prep

Computers for the Workplace

Food Insecurity

Housing Assistance

Guidance with Career Exploration

Guidance with the College Admissions Process

Fitness Memberships

Enrichment Programs

College Scholarship

MBTA Pass for employment transportation

Other:

Are you a Veteran *

Yes

How are you actively working your recovery? Is it helping you to maintain your sobriety? Please explain.

If applying for Housing Assistance , please list the name of the facility, address, phone number and contact person, anticipated move in date.

**Approval is based on confirmed housing, please indicate if you are looking for sober housing.**

How will approval of your request assist you in maintaining your sobriety and achieving personal and professional advancement?

Please include the name, email, and phone number of someone who can speak on your behalf as a referral.

Are you currently employed ? Please share a brief description of your work experience.

I identify my ethnicity as

Asian

Black / African

Hispanic / Latin

Caucasian

Native American

Pacific Islander

I prefer no to

Other:

Your signature: FILL IN YOUR FULL NAME

Check to confirm your signature:

Option 1

DATE:

Recovered Souls will respond to your inquiry shortly. We look forward to connecting with you to see how we can be of assistance.

A copy of your responses will be emailed to the address you provided.

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