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Suggest a Halfway House
Addition/Update

 

 
All fields marked ‘*’ are required fields
 
 
About You

First Name Last Name
e-Mail address

 
  Request Type Request to   a halfway house
  Reason for request

  Name of Facility
  Address
  State
  City
  Zip Code
  Contact Name  
  Contact Telephone   (nnn-nnn-nnnn)
  Facility Telephone   (nnn-nnn-nnnn)
  Facility Fax   (nnn-nnn-nnnn)
  Website  
  Email Address  
  Alternate Contact Name  
  Alternate Telephone   (nnn-nnn-nnnn)
  Required Deposit  
  Rent Rate     per: Week Month

   

Special Conditions

  Local County Residents Only? Yes    No
  Genders Accepted Male    Female    Both
  Faith Based? Yes    No
  Sex Offenders Allowed? Yes    No       Sex Offender Conditions:
  Electronic Monitoring Allowed? Yes    No    Electronic Monitoring Conditions:
  Major Medical Allowed? Yes    No    Major Medical Conditions:
  Major Mental Allowed? Yes    No    Major Mental Conditions:
  Additional Comments
 
  Our Mailing Address 2925 Gulf Freeway South
Suite B #229
League City
Texas, USA. 77573