Sober Living & Re-Entry Residency Application

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Fields marked * are required. The $80 background check fee is non-refundable and paid at intake.

01Personal information

Legal first name *

Middle name

Legal last name *

Preferred name

Date of birth *

Last 4 of SSN *

Mobile phone *

Email *

Current address (or where you are staying now) *

City *

State *

ZIP *

Current living situation *

Photo ID type *

02Emergency contact

Full name *

Relationship *

Phone *

03Housing request

Location

Charlotte, NC Southwest Charlotte · 28217

Desired move-in date *

Lease length (12-month minimum) *

How did you hear about us? *

Referring person or agency

Their phone

Their email

04Your recovery

Our homes are alcohol- and drug-free. These questions help us make sure our housing is a good fit for you. This information is kept confidential.

Sobriety date (last use of alcohol or non-prescribed drugs) *

Primary substance(s) you are in recovery from *

Are you currently in, or have you completed, a treatment program? *Currently in treatmentCompleted treatmentNo formal treatment

Program name

Start date

End or expected end date

Program counselor or contact

Counselor phone

Are you currently prescribed any medications you will keep at the home? *YesNo

Prescribed medications, including medications for opioid or alcohol use disorder such as buprenorphine, methadone or naltrexone, do not disqualify you. All residents follow our medication storage policy. You do not need to list your medications here.

Have you lived in a sober living home before? If yes, where, when, and why did you leave?

05House standards

Every resident agrees to these standards. Please check each one to show you understand and agree.

I will not use or possess alcohol, illegal drugs, or non-prescribed medications on or off the property.I will be employed within 30 days of move-in and stay employed while I live here.I will complete my assigned household chores and keep my space clean.I understand that no guests are allowed at the house.I will treat residents and staff with respect. Violence, threats, and theft result in immediate dismissal.I understand the house's relapse policy, which will be reviewed with me at intake.

06Income & payment

Employer

Position

Monthly income (all sources) *

Who will pay your housing fees? *

If someone else is paying: name and phone

07Legal history

A criminal record does not automatically disqualify you. We review every application individually, considering the nature of any offense, how long ago it happened, and what you have done since.

Are you currently on probation, parole, or in a drug or treatment court program? *YesNo

Officer or case manager

Their phone

Supervision end date

Have you been convicted of a felony or misdemeanor in the past 7 years? *YesNo

If yes, describe the offense(s), dates, and anything you would like us to know

Do you have any pending criminal charges? *YesNo

Are you required to register as a sex offender? *YesNo

08Housing history (past 2 years)

Most recent address

Dates (from – to)

Landlord or contact name and phone

Reason for leaving

Previous address

Dates (from – to)

Landlord or contact name and phone

Have you ever been evicted? *YesNo

If yes, please explain

09In your own words

Why are you seeking sober living now? *

What are your goals for the next 6 months? (work, school, family, health, recovery) *

What has helped you most in your recovery so far?

Is there anything you need from us, such as a reasonable accommodation, to live here successfully?

10References

Two people who know you well and are not family members. A counselor, sponsor, employer, or case manager is ideal.

Reference 1: Name *

Reference 1: Relationship *

Reference 1: Phone *

Reference 2: Name *

Reference 2: Relationship *

Reference 2: Phone *

11Documents

Please don't upload documents here. Bring the following to your intake interview, or we'll tell you how to send them securely:

Photo ID
Proof of income (pay stub, award letter, or agency letter)
Treatment completion or referral letter (if available)
Other supporting documents

No ID yet? You can still apply. We'll talk about next steps at intake.

12Consent & signature

I authorize LIT Homes to conduct a background check and to contact the references, landlords, and program contacts I listed.I authorize LIT Homes to share updates on my residency with my referring agency or treatment provider. (A separate release form will be signed at intake.)I certify that the information in this application is true and complete. False or incomplete information may result in denial or termination of residency.I understand the $80 application fee, which covers my background check, is non-refundable and that submitting this application does not guarantee a bed.

Type your full legal name as your signature *

Date *

Your information is kept confidential and used only to review your application. See our Privacy Policy.