Application for Limited Financial Scholarship
Create an account, then complete the application. Progress is saved automatically. Our team will review and contact you within 2–3 business days. Please feel free to contact Madison or Lisa if you have questions or if you have not heard from either by the 15th of the month.
Before You Begin
Please read and acknowledge the following before starting your application.
Liability Release & Terms of Use
By proceeding with this application, you acknowledge that The Sobriety Resource (“TSR”) and its affiliated providers collect personal, financial, and health-related information for the sole purpose of evaluating your eligibility for housing and recovery assistance programs.
Accuracy of Information. You certify that all information provided in this application is true, accurate, and complete to the best of your knowledge. Submitting false or misleading information may result in disqualification from all TSR programs and may be subject to applicable legal consequences.
Confidentiality. TSR treats all submitted information as confidential in accordance with applicable federal and state law, including 42 CFR Part 2 (substance use disorder records) and HIPAA where applicable. Information will not be shared with third parties without your written consent, except as required by law.
No Guarantee of Services. Submission of this application does not guarantee admission to any program, placement in housing, or receipt of any benefit. Eligibility determinations are made at the sole discretion of TSR and its partner providers based on program capacity, funding availability, and individual need.
Release of Liability. You agree to release, discharge, and hold harmless TSR, its officers, employees, volunteers, and partner organizations from any claim arising out of or related to the application review process, eligibility decisions, or program participation, except in cases of gross negligence or willful misconduct.
Electronic Signature.By checking the box below and clicking “Begin Application,” you are providing your electronic signature and consent to the terms above, which carries the same legal weight as a handwritten signature.
This electronic signature is legally binding under the ESIGN Act (15 U.S.C. §7001).