Restoration Enrollment

Great job taking the first step toward getting help! We just need you to complete the Restoration Enrollment form below, and a member of our Restoration team will reach out shortly to get you started in the program.

Restoration Enrollment Form

1. General Information
2. Church Information

If you're a member of a church, we'd ask that you let your pastor know your intentions of coming to Music of Life Church - Kimberly for help in this area. You do not need to be a member of Music of Life Church - Kimberly to go through The Restoration Process but we want to respect the spiritual covering you currently have through your pastor.

3. Counseling Information

If you're seeing a counselor, we'd also appreciate you getting their permission. We want you to be given clear direction for dealing with your mental and emotional life and we don't want to get in the way of any process that is working for you.

4. Marriage Information

If you're married, we'd appreciate you making your spouse aware. We're not asking you to get "permission" to do The Restoration Process. We are just trying to facilitate open communication with your spouse.

5. Tell us about why you want Restoration
6. Definitions

The definitions of key words is paramount to the Restoration Process. With that said, can you please state what your definitions are for the following words? If you're unsure about how to define any of them, we encourage you to give it a try. It is better to state an answer rather than no answer at all.

7. Questions