freedom. healing. surrender

INTAKE INQUIRY

First Name

Last Name

Phone Number

Email

Date of Birth

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Have You Ever Been To A Teen Challenge

Do you have physical forms of ID?

Have you ever been diagnosed/treated for mental health issues?

Briefly tell us your current situation or why you are applying for Adult & Teen Challenge?

How did you hear about Brooklyn Adult & Teen Challenge?

Gender

You're making the best decision of your life! Freedom is waiting!
Call the number below to get directly connected to our
Intake Coordinator.
917-982-8448

We are committed to helping you at this critical point in your life. By calling, you will begin the intake process which has a few steps. Here is some basic information to help you start.
A Little About Who We Are:

A year long residential discipleship program for men struggling with life-controlling issues.
Distinctly Christian, but we accept everyone who is willing to come and agree to our process and procedures.
Here to serve…we believe in you!

Some Things We Require:

Completed Application
Physical and other medical information
Intake fee
A commitment to change

Don’t worry, we’re here to help. If you have any questions along the way, don’t hesitate to ask. If we can’t serve you, we’re committed to helping you get connected to another Teen Challenge Center that may be better suited to provide the help you need. We are part of a network of over 200 centers in the US and over 1,200 globally.

< Back

Next >

Submit

When we Meet

Sunday Mornings

9:30 am and 11:00 am

Sunday Evenings

6:00 pm

freedom. healing. surrender

When we Meet

Sunday Mornings

Sunday Evenings

How To Contact Us

We'd love to hear from you. Fill out the form below to get started.