FRH Program Participant Forms

2023 FOUNDATIONS OF RECOVERY - HORSES IN MINISTRY (FoR-HiM)

Adult Onboarding Survey

Name:

Birthdate:

T-shirt size:

Mailing Address:

Email:

Phone:

THE FOLLOWING QUESTIONS ARE FOR THE APPLICANT TO ANSWER (There are no right or wrong answers. Please respond in a way that is true for you.) Enter today's date here:

1) Tell me about your experience with horses, if any.

2) Do you have physical limitations that may inhibit you in any way from standing, squatting, walking, bending, lifting, etc.? If so, please explain. (Physical, emotional or mental limitations will not necessarily affect your acceptance to the program. We just need to be aware of how to serve you best.)

3) Are you willing to commit to attending all six weekly sessions, to being on-time and prepared to learn? (See the email we sent with the program schedule.)

4) Are you willing to spend up to two hours doing homework assignments, outside of class each week?

5) Do you have access to the Internet and a device on which you can receive emails and view documents, as well as listen to an MP-3 file/recording?

6) Tell me about your history and/or lived experience with mental health and/or substance use challenges:

7) Do you feel well-supported by your family in your recovery from life's hurts, hang-ups & habits?

8) I attend recovery meetings, Church group(s) and/or Bible study regularly. 2) [If “never,” skip questions 11 & 12]

9) I feel well-supported by others in my recovery group(s), Church group(s) or Bible study?

10) I have completed or am currently working the 12 Steps of Recovery with a sponsor and/or a recovery group.

11) How true is this statement for you? “My best life in recovery requires that I get and stay connected to others who are also actively living a life committed to Jesus Christ.” (Your answer, one way or another, does not affect your acceptance to the FoR-HiM program.)

12) Do you have at least one person you would call a true friend that does not use drugs or alcohol?

13) Do you have healthy (clean & sober) connections? These would be one or more people that you hangout with and call on a regular basis. They know you and consider you a part of their lives and vice-versa.

FOUNDATIONS OF RECOVERY - HORSES IN MINISTRY (FoR-HiM)

Youth Onboarding Survey

Youth's Name [THE YOUTH NAMED HERE SHOULD ANSWER QUESTIONS 1 THROUGH 11, BELOW.]:

Birthdate:

Youth's T-shirt size:

Parent/Guardian Name [THE PARENT/GUARDIAN NAMED HERE SHOULD ANSWER QUESTIONS, (A) & (B), BELOW.]:

Mailing Address:

Parent/Guardian's Email:

Parent/Guardian's Phone:

Please enter today's date here:

A) Parent/Guardian: Does the youth have physical limitations that may inhibit him/her in any way from standing, squatting, walking, bending, lifting, etc.? If so, please explain. (Physical, emotional or mental limitations will not hinder his/her acceptance to the program. If yes, we will send you a form to be completed by a physician.)

B) Parent/Guardian: Does the youth have access to the Internet and a device on which he/she can receive emails and view documents, as well as listen/view an audio/video recording?

THE FOLLOWING QUESTIONS ARE FOR THE YOUTH TO ANSWER (There are no right or wrong answers. Please respond in a way that is true for you.) Please enter today's date here:

1) Tell me about your experience with horses, if any.

2) Are you willing to commit to attending all six weekly sessions, to being on-time and prepared to learn? (See the email we sent informing you of the program schedule.)

3) Are you willing to spend up to two hours doing homework assignments, outside of class each week?

4) Tell me about your history and/or lived experience with Substance Use Disorder (addiction or drug/alcohol misuse) and/or other mental health challenges - either yours, or someone else's, or both. This could be your own drug and alcohol use, other mental health challenges or your struggle with another's drug and/or alcohol use or mental health challenges, now or in the past.:

5) Do you feel well-supported by your family in your recovery from life's hurts, hang-ups & habits?

6) I attend youth group, Church, and/or Bible study regularly. [If “never,” skip questions 7 & 8]

7) I feel well-supported in my life by others in my youth group, Church, and/or Bible study.

8) I have completed or am currently working the 12 Steps of Recovery with a sponsor and/or a recovery group.

9) How true is this statement for you? “My best life in requires that I get and stay connected to others who are also actively carrying through on a drug & alcohol-free life.”

10) Do you have at least one person you would call a true friend that does not use drugs or alcohol?

11) Have you made healthy (clean & sober) connections? These would be one or more people that you hangout with and call on a regular basis. They know you and consider you a part of their lives and vice-versa.

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Guys Mills, PA 16327

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