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Fill out the application below to begin your journey to a new life. Please ensure the phone number you provide is one we can easily reach you at. After reviewing your application we will give you a call to set up your interview. If you have any questions please call us at 336-376-5066. 

Do You Have a Valid Driver's License?

Emergency Contact Info

Emergency Contact Address
Spouse or Parent Contact Info
Are you a registered sex offender?
Do you have any pending court dates?
Are you taking any medications currently?
Have you ever been tested for the HIV Virus, Aids, or Hepititus?
Are you on probation or parole?

Living Free Ministries Men's program is a Christian-based Regeneration Program for men battling drug addiction and alcoholism. We are not a medical facility. You are required to handle all personal affairs before entering. You may not leave during your program to handle matters and then come back. If you have any questions about this please ask during your phone interview. 

Things to Bring: Clothing, personal hygiene Items, wash cloth, towels, shower shoes, bible, stamps, paper, envelopes.

Living Free is a tobacco-free facility, any tobacco found at intake will be disposed of. If you bring a cell phone it will be locked away and given back to you when you leave the program. A thorough bag search will be done on the day you arrive. 

Are you ready to make this life-long commitment to change your life?

Congratulations, you've made the first step to your new life!

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