Thank you for your interest in Kokum's House. If you or someone you know is ready to take the next step toward recovery, we invite you to complete our application form.

To apply:

1. Download the PDF application form using the link below.

2. Fill it out completely – either digitally (using a PDF editor) or by hand.

3. When you're ready, click the Submit Application button to open your email.

4. Attach the completed form and send it.

Please ensure all sections are filled out as completely and accurately as possible. Incomplete applications may cause delays in processing.

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If you have any questions or need help filling out the form, feel free to contact us—we’re here to support you.