Pre-Application Form

Apply for residency in The Gatehouse Hammond

The Gatehouse Hammond Pre-Application Form

Provide the following information for consideration of residency. Please fill out the form completely. All fields are required.

Do you have children? *

Emergency Contact Information

Use Information

Are you an alcoholic? *
Are you an addict? *

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Have you been detoxed? *

Medical Information

Are you on any medications? *

Legal Information

Do you have any outstanding warrants? *
Are you a convicted sex offender? *
Do you agree to the guideline of NO CELL PHONE DURING THE 30-DAY RESTRICTION PERIOD? *
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