Enhanced horizons transitional living program application

Thank you for your interest in Enhanced Horizons (EH) Center for Advancement. The Enhanced Horizons transitional living program is designed to help teens and young adults move toward self-sufficiency and successful adult living (this includes single mothers with children).

By providing housing, transportation, and other services, each young adult is given an opportunity to develop and work on individualized independent living goals in a positive, safe, and supporting living environment.

How long is the program? The length of time in the Enhanced Horizons program varies depending on the individual needs of the young adult. To obtain maximum benefit from the program, we anticipate that most residents will stay anywhere from nine (9) to twenty-four (24) months.

What is expected of residents? All residents will be required to:
  • Participate in the development of a personal service plan that outlines the goals and objectives that they hope to accomplish while in the program.
  • Engage in a minimum of thirty-five (35) hours per week of productive activities, such as attending school, working a full-time or part-time job, community service, and/or independent living skills training.
  • Will be expected to actively seek employment and to work at least part-time. Residents will pay a small portion of their paycheck for living expenses and will be expected to save funds during their stay at Enhanced Horizons.
  • Follow program guidelines and expectations.

What does it take to succeed in the program? Participants must have a certain level of maturity and a strong willingness to work with program staff and other residents to accomplish their individual program goals and objectives.

What are the eligibility requirements? To be eligible for the program, you:
  • Must be 18 to 24 years of age.
  • Must be in need of a dependable, safe place to live.
  • Must be committed to actively participating in EH program services.
  • Must be willing to follow program guidelines and expectations.
    Note: Couples and/or on-campus romantic relationships are not allowed.

    What are the application requirements? Applicants must submit the following:
  • An Enhanced Horizons Application Form
  • An Enhanced Horizons Release of Information Form to obtain educational, medical, and other relevant records.
  • A consent form for a Criminal History Check.
 
Enhanced Horizons Application

It is the policy of Enhanced Horizons (EH) and Hill Country Youth Ranch (HCYR) not to discriminate on the basis of race, color, national origin, sex, age, or handicap in its programs, services, activities, and employment practice as required by Title VI of the Civil Rights Act of 1964, as amended, Title IX of the Education Amendment of 1972, and Section 504 of the Rehabilitation Act of 1973, as amended. Enhanced Horizons will take steps to assure that lack of English language skills will not be a barrier to admission and participation in all residential, educational, and vocational programs. Contact Brian Ellsworth, 149 Camp Scenic Loop, Ingram, Texas, 78025, phone (830) 367-4330 for information about your rights or grievance procedures.

Application Instructions

If you need assistance in completing this form, our staff is glad to assist you.

Please answer all questions as honestly and as accurately as you can. if you have any questions, please call us at (830) 367-4330 ext. 222 for assistance.

For driving directions to Enhanced Horizons, call (830) 367-4330 ext. 222.

First Name:
Middle Name:
Last Name:
Maiden Name and/or Other Legal Names by Which you have been known:
Date of Birth:
Age:
Phone number 1:
Phone Number 2:
Address 1:
Address 2:
City:
State/Province/Region:
Country:
ZIP/Postal Code:
Email:
Part 1: Referral Source
If you were referred to EH by someone in an organization, please provide the following information:
Name of Organization:
Name of Contact Person:
Phone Number:
If you were referred to EH by someone you know personally, please provide the following information:
Name of Person:
What is their relation to you:
Phone Number:
If no agency or person referred you, how did you learn about Enhanced Horizons?:

Part II: Living Situation
Where do you currently reside?:
How long have you lived at your current residence?:
Where did you live before your current place of residence?:
Over the past year, where have you lived the longest?:

Part III: Education
Highest grade you have completed in school::
If you did not complete elementary or high school, please indicate why.:
Do you have a high school diploma?:
Did you complete the GED?:
Have you taken college courses?:
Are you currently attending school?:
If you are currently attending school, please complete the information below.
Name of School:
Hours Attended Per Week:
What is the name of the last school that you attended?:
Did you attend full time or part time? :
Part IV: Work, Financial Status, and Transportation
Are you currently Employed?:
If Yes, please list the name of your current employer(s) and indicate the number of hours you work per week at each job:
Name of Employer:
Hours Worked Per Week:
If you are NOT working, please check the statement below that best describes your current situation::
What are your other sources of income or public assistance? (Check all that applies):
Other sources of income not listed above:
Are you currently in debt?:
If you chose Yes above, please explain what type of debt and the amount owed.:
Please indicate your current means of transportation. (Check all that apply.):
Please list any other means of transportation that you use:

Part V: Social History
Have you ever been in trouble with the law?:
If Yes, please explain:
Have you ever been arrested?:
If Yes, please explain:
Have you ever had trouble with drugs or alcohol?:
If Yes, please explain:
Have you ever received counseling?:
If Yes, please explain:
If yes, was counseling helpful?:

Part VI: Medical/Mental Health History
Have you had any serious illnesses during the past five (5) years?:
If Yes, please describe:
What is the present state of your physical health?:
Please list any physical problems or conditions that you may have:
Please list any medications that you are currently taking and the reason for the medication (including birth control):

Part VII: Marital and Family
Are You:
Are you expecting a child?:
If Yes, when is the due date?:
Doctor's Name:
Do you have children?:
If Yes, how many children do you have?:
Please provide the following information about your children.
Name:
Date of Birth:
Gender:
Do you have custody?:
Do any of your children have medical problems?:
List any medications your children may be taking and the reason for the medication.
Child's Name:
Medication:
Reason:
Part VIII: Personal Statement
Please tell us why you would like to enter the Enhanced Horizons program. What are your personal goals and how can this program help you achieve your goals?: