Select the program you are applying for below.

  • Be sure to mark which program you are applying for.
  • We will contact you to follow up on the next business day after you submit the form. (If you fill out the form on a Friday or a weekend, we will be in touch with you on Monday.)
  • Click here for Frequently Asked Questions.
  • You may contact us at 205-424-HOPE (4673) for questions or more information.

Men’s Recovery Application

Please complete the application to request intake at the Bessemer Campus.

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Men’s Recovery Farm Application

Please complete the application to request intake at the Cullman Foundry Farm Campus.

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Women’s Recovery Application

Please complete the application to request intake at the Bessemer Campus.

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Rescue Application

Please complete the application to request assistance for the Rescue Program.

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Re-Entry Application

Please complete the application to request intake to the Re-Entry Program.

Apply now