1/99 Reintegration Application
1/99 is designed to support survivors of commercial sexual exploitation during a transition to independence, after successful completion of a long-term residential program(s). 1/99 is a 1-2 year long program, with the intended benefit of developing life-long communal and relational supports for participants. The purpose of this program is to come alongside participants, provide a safe haven and guide rails for walking out God's purpose and plan for their life.
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Before You Begin:
We are honored you have chosen to apply with us! A few things to consider before you begin this multi-step application process:
All applicants must:
-be 18 years or older
-have a recommendation from current/previous residential program
-participate in a face-to-face interview prior to acceptance to program
-complete an intake meeting after acceptance
-agree to 1/99 Transitional Housing guidelines
-be working or ready to seek employment
-be ready to set a budget including money for housing
-adhere to program requirements including but not limited to: submitting random drug tests and working with a mentor

First and last name: *
Date of birth: *
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Current address (or current residential program name): *
Phone number *
Email address:
First language: *
Do you have children in your custody (if you are working to regain custody, provide some detail in the "other" section)? *
If yes, how many children and what ages?
Are you pregnant? *
What race/ethnicity do you identify as? *
Current employment status? *
What is your annual income range (consider income from employment, TANF, food stamps and other sources)? *
Last level of education completed: *
Tell us about activities that bring you joy (i.e. what do you do in your free time? Is there something you can easily do for hours and lose track of time?) *
In a few sentences, give us the highlights of your religious background (i.e. faith preference/denomination? Do you currently have a church home?) *
Tell us about your family (Did you grow up with your biological parents, In foster care, etc.? Are you currently in relationship with the person/people who raised you?) *
How old were you when you moved from your parent’s home? *
Do you have any close friends, family, exes or significant others in the Kansas City metro area (Johnson, Wyandotte and Jackson counties)? *
Do you have a history of substance abuse? *
If so, have you received treatment of any kind? (Check all that apply) *
Required
Date of last use?
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Do you have a therapist/psychiatrist you meet with regularly? *
Do you currently have any pending legal charges? *
List any convictions and pending charges on your record and the county in which you received it. *
Upon acceptance to the 1/99 program, I give permission for my first name only to be shared with necessary staff and volunteers so they may prepare for my arrival. *
By submitting, I am indicating all my answers are true and accurate, to the best of my knowledge. Furthermore, I intend to commit to following program guidelines should I be accepted to the 1/99 program. *
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