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Application

To be eligible for participation in the 12-month transitional housing program, the applicant must:

18 or older
Have been convicted of a sex offense
Be, or willing to be, currently vaccinated (inculding COVID)
Comply with mental and physical health recommendations from their medical provider
Complete an interview with a staff member
Be motivated to live a crime-free life

Program

To remain in the program, the resident must:

Be willing and able to work and provide pay stubs
Refrain from using or possessing drugs, alcohol, pornography, or weapons
Follow the individual case plan designed for them
Pay $550 per month for rent. The first month will be $250 or less, depending on arrival date.
Respect all residents and staff

Online Application

First Name (Required)

Last Name (Required)

Middle Name

E-mail Address (Required)

DOC # (Required)

Age (Required)

DOB (Required)

Race (Required)

Current Address

Address (Required)

City (Required)

State (Required)

Zip Code (Required)

Emergency Contact

Name (Required)

Relationship (Required)

Address (Required)

City (Required)

State (Required)

Zip Code (Required)

Daytime Phone (Required)

Evening Phone (Required)

Alternative Emergency Contact

Name (Required)

Relationship (Required)

Address (Required)

City (Required)

State (Required)

Zip Code (Required)

Daytime Phone (Required)

Evening Phone (Required)

Health Information

Have you been given a clinical diagnosis in the last ten years? If yes, please explain: (Required)

List any treatment and/or prescribed medication:

Are you willing and able to work a full-time job? (Required)

If no, please explain (Required)

Are you currently taking any prescription medication? If yes, please list: (Required)

Have you ever been prescribed medication for a mental health diagnosis? If yes, please list the diagnosis and all associated prescription medications:

Do your mental health concerns affect your daily living? If yes, please explain:

Are you vaccinated for COVID? If not, are you willing to get vaccinated for COVID (required for acceptance to our program)? (Required)

Have you been tested for tuberculosis (TB) in the past 12 months? (Required)

If yes, what were the results of the test? (Required)

Alcohol and Drug History

Do you now or have you ever abused drugs or alcohol? (Required)

If yes, please list your those drugs, including alcohol: (Required)

Did you attend and/or complete treatment:

How do you plan to stay drug free/sober? (Required)

Education

Highest Grade Completed (Required)

GED?

Did you attend college? (Required)

Do you have a degree? (Required)

Type of degree

What school did you attend?

Do you have trade skills? If yes, which trade (Required)

Do you have a trade certificate? (Required)

Military Service

Have you served in the military? (Required)

Do you have Combat Experience?

Years of Service

Type of Discharge

Employment History

Were you employed at the time of your arrest? (Required)

If so, where?

What type of work?

Do you have a disability of any kind? (Required)

If yes, please explain:

What is your employment plan or desire upon release?

Criminal Record

Current Charge(s) (Required)

Current Conviction (if different)

Current Sentence (Required)

When were you incarcerated on these charges? (Required)

Date Incarcerated (Required)

Parole Date (Required)

Expiration Date (Required)

Institution (Required)

Was this a Parole/Probation violation? (Required)

If yes, what were the circumstances of the violation? (Required)

How long were you in the community before you violated?

Upon release, will you be under supervision in the community? (Required)

Will you be required to register on the sex offense registry? (Required)

Are there any other conditions of your supervision: (Required)

Will you be, or are you on Lifetime Supervision (ankle monitor)?

Past Criminal History

Number of Previous Adult Felony Convictions (Required)

Number of times incarcerated (Required)

Number of years (of your adult life) that you have spent in prison (since age 18): (Required)

Have you spent time in juvenile facilities? (Required)

If yes, what were the charges? (Required)

Please list ANY and ALL violations received in the past 3 years of your incarceration (Required)

Please list any additional information about yourself that might be pertinent in our decision to admit you to our program?

Signature

Applicant Signature (Type your name) (Required)

Date (Required)

Current Facility (if applicable)

PO or Case Worker Contact Info (if applicable)

Paper Application

Download and complete the form. Answer ALL questions. After we receive your completed application, we will be reaching out to you to schedule an interview to determine program eligibility.

Mail the completed application to:

Viewpoints
PO Box 1286
Ballwin, MO 63022

For faster response, email your application to info@viewpoints-stl.org

Download the Transitional House Application