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We are excited to announce the opening of our new men’s Life Recovery Program campus. Click here to learn more.

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  • About Us
    • Our Mission
    • Financial Integrity
    • Statement of Faith
    • Careers
    • Contact Us
  • Get Help
    • Survival Outreach Services
    • Life Recovery Program
    • The Family Shelter
    • Other Resources
  • Thrift Stores
  • Ways to Help
    • Volunteer
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DONATE
San Fernando Valley Rescue Mission logo
  • About Us
    • Our Mission
    • Financial Integrity
    • Statement of Faith
    • Careers
    • Contact Us
  • Get Help
    • Survival Outreach Services
    • Life Recovery Program
    • The Family Shelter
    • Other Resources
  • Thrift Stores
  • Ways to Help
    • Volunteer
    • Take a Tour
    • Giving
  • Stories
  • About Us
    • Our Mission
    • Financial Integrity
    • Statement of Faith
    • Careers
    • Contact Us
  • Get Help
    • Survival Outreach Services
    • Life Recovery Program
    • The Family Shelter
    • Other Resources
  • Thrift Stores
  • Ways to Help
    • Volunteer
    • Take a Tour
    • Giving
  • Stories

LIFE RECOVERY PROGRAM APPLICATION

Name(Required)
MM slash DD slash YYYY

Program Overview

We offer a free, Christian faith-based recovery program for men experiencing homelessness and addiction. You do not need to be a Christian to enter the program, but our teaching will come from a Christian perspective. Our program requires a minimum 10 month commitment. The program consists of daily classes made up of life skills like money management, career readiness, and healthy relationships, in addition to Bible classes, discipleship classes, and relapse prevention. Participants also spend 25 hours a week at our thrift store where they learn and practice valuable soft skills like showing up on time, conflict resolution, receiving constructive criticism, and team work. Men who complete 7 months of the program will begin working on finding a job and saving money. After 10 months, men may choose to stay and work on finding housing or go to school for an additional 9 months.

Primarily we are looking for two qualities in a participant: Someone who is ready to work on their recovery and someone who can do the basics of the program. Men who feel they meet those qualities may apply. We are a drug, alcohol and nicotine-free program. A drug test will be required upon intake appointment. Men must be experiencing only minor detoxification.

Marital Status
Primary Language
Are you able to read full books in English?
Do you have children
Children
Name
Age
 

Education

Do you have one of the following:
Do you have a:
Do you have any outstanding debt:

Legal History

Have you been convicted of any sexual or violent crimes?(Required)
Are You Currently on Probation?(Required)
Do you have any pending legal issues?(Required)
Are you a Registered Sex Offender?(Required)
Have you ever been incarcerated?(Required)
List
Reason
Length
 
Are you now or have you ever been affiliated with a gang?(Required)
Are you willing to commit to fully completing the 10 month program, even if your legal terms end sooner (If Applicable)?(Required)
Are you willing and able to sit through hour-long classes and participate in a group setting?(Required)

Medical History

Do you currently have medical insurance?(Required)
Are you taking any medication prescribed by a doctor?(Required)
List
Medication
Dosage (strength times per day)
Reason
 
Are you seeing a doctor due to Behavioral/Mental Health reasons?(Required)
Have you recently seen a Psychiatrist or Psychologist?(Required)
Are you taking medication related to Mental Health?(Required)
Do you have any significant or relevant medical issues?(Required)
Do you smoke?(Required)
If you smoke, are you willing and able to stop?

Drug History

Please answer for all substances used:
Tobacco / Tabaco
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Alcohol / Alcohol
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Crack / Piedra
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Marijuana / Marihuana
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Meth / Clabo
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Speed / Acelerantes
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
IV Drugs / Drogas Endovenosas
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
PCP / PCP
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Powder Cocaine / Cocaína de Polvo
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
Other
Drug
Years Used / Años de Uso
Frequency / Frecuencia
Last Used / Ultima vez usada
 

Can you lift 40 pounds?(Required)
Can you stand for 2 hours at a time sorting clothing?(Required)
Can you climb into a bunk bed?(Required)
Developing a stronger relationship with Jesus:(Required)
Help with your addictive behavior:(Required)
Healthy and stable place to live for 10 months:(Required)
Classes on money management, computer skills and career development(Required)
Working in our thrift store every day:(Required)
Being randomly tested for drugs and alcohol:(Required)
Satisfying legal obligations:(Required)
Looking for employment and affordable housing:(Required)

Spiritual Information

Do you attend church?(Required)
Are you willing to attend weekly Bible study and a Christian Church on Sundays?(Required)
Thank you for providing this information. The next step will be an evaluation of your application. We have a waitlist that fluctuates determined by a number of factors. If you’re determined to be good fit for our program and your waitlist spot comes up, we will hold a spot for you while we work out details with a parole officer, public defender, or other contact. On average it takes about a month on our waitlist for a bed to become available.

The San Fernando Valley Rescue Mission is an outreach ministry of the Rescue Mission Alliance. Learn more

Explore the RMA Family

Ventura County Rescue Mission

Victor Valley Rescue Mission

Central Coast Rescue Mission

Valley Food Bank

Contact

8756 Canby Ave.
Northridge, CA 91325

Office
(818) 785-4476

Shelter Intake
(818) 960-0404

Renewed Hope Recovery Program
(818) 960-0408

To schedule a pickup:
1-800-417-5678

Liz Duran, Community Relations
818-474-1287

San Fernando Valley Rescue Mission logo
DONATE
Certified Excellent
ECFA Accredited
Charity Navigator logo

The Rescue Mission Alliance is firmly committed to the highest standards of financial and institutional integrity. We fully support the purpose and goals of the Evangelical Council for Financial Accountability and display its seal proudly to reflect compliance with its membership standards. We also maintain a "Certified Excellent" member status with Citygate Network. In addition we have earned Charity Navigator's highest rating of 4 stars.

The San Fernando Valley Rescue Mission is an outreach ministry of the Rescue Mission Alliance. Learn more

Explore the RMA Family

Ventura County Rescue Mission

Victor Valley Rescue Mission

Central Coast Rescue Mission

Valley Food Bank

Contact

8756 Canby Ave.
Northridge, CA 91325

Office
(818) 785-4476

Shelter Intake
(818) 960-0404

Renewed Hope Recovery Program
(818) 960-0408

San Fernando Valley Rescue Mission logo
DONATE
Certified Excellent
ECFA Accredited
Charity Navigator logo

The Rescue Mission Alliance is firmly committed to the highest standards of financial and institutional integrity. We fully support the purpose and goals of the Evangelical Council for Financial Accountability and display its seal proudly to reflect compliance with its membership standards. We also maintain a "Certified Excellent" member status with Citygate Network. In addition we have earned Charity Navigator's highest rating of 4 stars.

San Fernando Valley Rescue Mission logo
DONATE

The San Fernando Valley Rescue Mission is an outreach ministry of the Rescue Mission Alliance. Learn more

Explore the RMA Family

Ventura County Rescue Mission

Victor Valley Rescue Mission

Central Coast Rescue Mission

Valley Food Bank

Contact

8756 Canby Ave.
Northridge, CA 91325

Office
(818) 785-4476

Shelter Intake
(818) 960-0404

Renewed Hope Recovery Program
(818) 960-0408

Certified Excellent
ECFA Accredited
Charity Navigator logo

The Rescue Mission Alliance is firmly committed to the highest standards of financial and institutional integrity. We fully support the purpose and goals of the Evangelical Council for Financial Accountability and display its seal proudly to reflect compliance with its membership standards. We also maintain a "Certified Excellent" member status with Citygate Network. In addition we have earned Charity Navigator's highest rating of 4 stars.

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