Welcome To

Kim's Place

Kim’s Place is a place a refuge, a sober living home that caters specifically to those who have left the life of the sex industry including trafficked women.

What is it Like?

The home is adorned with positive messages, and each woman is assigned a mentor to assist in her transition.

Our goal is to give each woman her dignity and the power over her own life back to her, and to help her transition into her own home, a job, and safety.

TAKE A VIRTUAL TOUR OF KIM'S PLACE

There is a new start... tomorrow. At Kim's Place --a place of healing (1)

Kim’s Place Program Application

Full Name (First, Middle, Last):

Email Address:

Date of Birth:

Phone

Current Address:

Street Address City State / Province / Region ZIP / Postal Code Country

Monthly Payment or Rent:

Marital Status:

How many NA/AA/CR meetings do you attend each week?

Do you have any criminal history?

If so, please explain:

Explain your experience in the sex industry:

Have you been physically abused?

If yes, do you have a restraining order against your attacker?

Have you ever been convicted of a sex crime and/or arson charge?

If so, please explain:

Have you ever been trafficked?

If so, how many years?

Please enter a number less than or equal to 99.

Employment Information:

Are you currently Employed?

If “yes” where?

What do you expect your income to be next month?

If you don’t have a job are you planning on getting one?

Are you getting welfare or other non-job related income? If “yes” what?

Do you have an EBT card?

If not how are you planning on paying for food?

Emergency Contact:

Name of person not residing with you:

First Last

Address:

Street Address

Phone:

Relationship to you:

Drug and Alcohol Use History/ Recovery Plan:

Please list drugs used addictively:

Did you abuse alcohol:

Did you use marijuana?

Do you have a sponsor?

Do you consider yourself an alcoholic and/or drug addict?

Have you been to a treatment center? If so which one(s) and for how long?

Do you have a medical doctor? If “yes”, list the doctors name and phone number:

Do you take prescription drugs? If “yes”, what are they and what are they prescribed for?

Other Information:

Have you ever lived in a recovery home before? If “yes” where?

If you have lived in a recovery home, what was the reason for leaving?

When are you available to move in?

Comments or Concerns:

Date

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Get In Touch

Portland, OR
+1 (971) 415-0007
businessagainsttrafficking@gmail.com