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Step Zero Society Scholarship Application

Supporting Your Next Step in Recovery

Step Zero Society offers partial scholarships to individuals in the DFW area of Texas seeking to transition into sober living. Scholarships are paid directly to approved sober living facilities. To be eligible, applicants must meet all criteria listed below and agree to ongoing participation requirements.

Date of Birth

Phone Number

Email

Address

Prefered Method of contact
Phone/text/email

Please fill Out the form below & we will be in contact soon

Full Name

Treatment Information

current treatment facility

Facility address

Facility Phone number

date admitted

Estimated completion date

therapy & support Information

Are you currently participating in:

Therapist/Group Counselor Name

Contact Info

Frequency of Attendance (e.g. 2x/week, weekly, etc.)

Consent to Contact Therapist for Verification:

Individual Therapy

Group Therapy

Both

Yes

No

Sober Living Placement

Prospective Sober Living Facility Name

Facility Address

Contact Person at Facility (Name, Title)

Monthly Program Cost

Phone Number

Email

Commitment to Program Requirements

Checkboxes (All must be checked to continue)

I agree to maintain continuous sobriety.

I agree to attend individual and/or group therapy.

I agree to participate in group fitness (e.g. Jiu-Jitsu, Run Club).

agree to volunteer 1 hour per week for Step Zero Society.

I agree to submit a video testimony sharing my story for use in Step Zero Society’s fundraising and promotional efforts.

I understand scholarship funds are paid directly to the sober living program.

Personal Statement

Please share your recovery journey so far, your goals in sober living, and how this scholarship will help support your transition.

Authorization & Consent

Checkboxes (All must be checked before submission)

I certify that all information provided is true and accurate.

I authorize Step Zero Society to contact my treatment provider, therapist, and sober living program for verification.

I understand that failure to maintain these commitments may result in the suspension of scholarship funds.

I authorize the use of my video testimony for promotional and fundraising purposes by Step Zero Society.

Signature

Submit

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Step 0 society

Step Zero Society Scholarship Application

Supporting Your Next Step in Recovery

Date of Birth

Phone Number

Email

Address

Prefered Method of contactPhone/text/email

Please fill Out the form below & we will be in contact soon

Full Name

Treatment Information

current treatment facility

Facility address

Facility Phone number

date admitted

Estimated completion date

therapy & support Information

Are you currently participating in:

Therapist/Group Counselor Name

Contact Info

Frequency of Attendance (e.g. 2x/week, weekly, etc.)

Consent to Contact Therapist for Verification:

Sober Living Placement

Prospective Sober Living Facility Name

Facility Address

Contact Person at Facility (Name, Title)

Monthly Program Cost

Phone Number

Email

Commitment to Program Requirements

Checkboxes (All must be checked to continue)

Personal Statement

Please share your recovery journey so far, your goals in sober living, and how this scholarship will help support your transition.

Authorization & Consent

Checkboxes (All must be checked before submission)

I certify that all information provided is true and accurate.

I authorize Step Zero Society to contact my treatment provider, therapist, and sober living program for verification.

I understand that failure to maintain these commitments may result in the suspension of scholarship funds.

I authorize the use of my video testimony for promotional and fundraising purposes by Step Zero Society.

Signature

Step zero society

Prefered Method of contact
Phone/text/email