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NextStep for Life

Transition for young adults.

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Next Step for Life Pre-Screen Application

Your city and state (ex: Cookeville, TN)
Please enter a valid phone number where our intake coordinators can reach you.
If you are filling this out for an individual who is incarcerated, please specify that they are incarcerated along with the name of the facility and the city and state in which it is located.
In order to help us reach more individuals,, if you have been referred by an individual or organization, please specify in this box.
May we contact the above individual or organization who referred you to us on your behalf?
Please separate with commas. (example 4 Kids ages: 1, 3, 8, 10 would be 1,3,8,10)
If your children are not with you please specify who has custody either an individual or an organization such as Department of Childrens Services.
Residents of the Next Step for Life program are not allowed to have cell phones.
Please be specific. If you have court dates, please mention when and where as well as the city and state.
Please be specific.
If the person named in this application is in a facility, please provide the facility name here.
If you have never had one, please say "I have never had one".

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About NextStep

Providing transitional living to adults with an intact family structure and encouraging growth by teaching spiritual, emotional, mental, and physical principles and practices for success.

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Next Step for Life
2300 W. Jackson St.
Cookeville, TN 38501

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