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PRE-APPLICATION QUESTIONNAIRE

Do you need a new normal? Healing and wholeness?

If you are interested in finding out more about Arukah House, fill this out and we will give you a phone call and chat about possible next steps.

Order Number

First Name *

Last Name *

Email Address *

Address *

City *

State *

Zip Code *

Phone Number *

Why are you considering Arukah House? *

Are you willing to submit to the Christian leadership and principles of Arukah House? *

Yes No

Do you agree to refrain from emotionally and/or sexually entangling relationships while at Arukah House? *

Yes No

Do you agree to refrain from alcohol and/or drugs while at Arukah House? *

Yes No

Do you agree to seek, accept, and keep full time employment while at Arukah House? *

Yes No

Do you agree to develop and maintain a budget and goals while at Arukah House? *

Yes No

Message / Comments

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