If you are interested in entering Bethel for help with your addiction(s), first review the
“About Us, Schedule and Testimonies” sections on this website. Then complete (in English)
the following application form and we will contact you within 72 hours after we receive your application to continue the application process. (We MUST speak with the applicant when we call.)

NOTE:Teenagers must be approved by one of our staff ministers.

Student Application to Bethel Colony of Mercy

1. Bethel Colony is a faith ministry which depends solely on donations.


2. Bethel Colony of Mercy is a Christian renewal center designed to help men who are truly ready to make a change in their life. Victory in living through Jesus Christ and the truth of the Bible is taught here. This is accomplished through classroom teaching, audio & video tapes, one-on-one counseling, homework assignments, worship services and work projects.

I have reviewed the info and willing to consider what Bethel has to offer
I Agree (required)

YesNo









YesNo         If not, GED? Yes





YesNo
(Must be detoxed at least 48 hrs, 72 hrs if on alcohol/opiates) If you come in requiring detox, you may be asked to leave and return after detoxification and WILL be required to start Bethel's program over once you have completed detoxification.






YesNo

YesNo

YesNo


YesNo


YesNo


YesNo


YesNo


YesNo

NOTE:  If you are a felon you must send a copy of your Criminal Record. If you choose to relocate in the Lenoir area when you leave Bethel, we may notify the local authorities.

3. The program at Bethel is for 65 consecutive days and we expect you to make a firm commitment to fulfill all 65 days.  Is there anything, including finances, that would prevent you from doing this? YesNo


4. Do you smoke? YesNo       Do you use smokeless tobacco? YesNo

We discourage smoking but allow it in designated areas only.  Cigarettes only; vapes, e-cigs, roll your own or any other form of tobacco are not allowed.

We have other rules we expect you to comply with such as limited TV choices and not leaving the grounds without permission, which is a check out offence.  You are required to participate in the daily work projects.  Work projects are designed to produce discipline and responsibility.  We are not a source of income.  We are a faith ministry and  there is no charge to stay here.  There is a non-refundable entry fee and we ask that you send it in before entering the program.  We also ask that you bring toilet paper, Tissue (Kleenex), paper towels, napkins, and laundry detergent when you check-in to Bethel, if possible.

5. HEALTH AND RELATED ISSUES.....

GoodFairPoor

YesNo




Medications:







YesNo





YesNo

Send a doctor's letter confirming your current status.

YesNo




YesNo
(If yes, you will need to speak with the Office Manager)

YesNo


DiabetesEmphysemaHeart ProblemsHigh Blood PressureUlcersANY sexually transmitted disease?


YesNo






We will also need a letter from your treating doctor or dentist confirming this.

PLEASE HAVE ALL PRESCRIPTION MEDICATIONS FILLED BEFORE COMING TO BETHEL.

You need to take care of any dental, vision or any other medical issues before entering this
program. We are not a medical facility nor do we have available the transportation to take
care of non-emergency medical needs.

The following is a list of medications NOT ALLOWED while at Bethel. They are listed with
brand name and generic name following in parentheses: valium (diazepam), xanax (alprazolam), serax (oxazepam), ativan (lorazepam), halcion (triazalam), dalmane (flurazepam),
restoril (temazepam), klonopin (clonazepam), tranxene (clorazepate), librium (chlordiazepoxide), sonota and ambien.



YesNo


6. How will you arrive at Bethel? (You cannot drive yourself)

7.   (a) Bring work and dress clothes (collard shirt & tie for Sunday morning service).
NO SLOGANS ABOUT BEER, BARS, DRUGS, SEX, WOMEN, TOBACCO, MUSIC or ANYTHING CONTRARY TO THE CHRISTIAN LIFESTYLE will be allowed.
(b) Bring your own washcloths and towels (mark your name on them). Bed linens are provided.
(c) Bring your own personal toiletry items (nothing with alcohol, ie; mouthwash, colognes, axe spray or aerosols)
(d) Bring a cloth mesh 36 x 24 laundry bag. (Can be purchased at Walmart.)
(e) NO BODY PIERCING RINGS OR STUDS WORN ANYWHERE ON YOUR BODY!
(f) No Radios/Walk-man/CD player/Tape player/MP3/DVD player/IPod and no cd's or dvd's. No video games or cards. No cell phones or lap-top computers. In other words; no electronic devices period.
(g) No over the counter medications.
(h) No caffeinated drinks or coffee.
Bring a Bible if you have one. No other reading material is allowed.

YesNo     YesNo

Yes (required)

Yes (required)



IF YOU HAVE ANY QUESTIONS REGARDING THIS APPLICATION PLEASE CALL
OUR OFFICE AT 828-754-3781. Within 72 hours of receiving your application someone
from our office will call you to complete your application process. WHEN WE CALL
WE MUST SPEAK TO THE PERSON APPLYING. In the case that we have not talked to
you within the 72 hours please contact our office to complete your application process.

Please make sure that you have filled in the contact phone numbers where
you can be reached.

**REMEMBER**

After completing and submitting your application we will need the results of two blood tests (HIV and TB) and the $250.00 Entry Fee before you will be called to come to Bethel. Once entered into the program this Entry Fee is non-refundable.

From time to time there is money given specifically to be put in a scholarship fund for those who have no way to pay the full Entry Fee. However, if money is available and you qualify to receive help you will be requested to make a particial payment. If you need more information on this you will need to contact the Office Manager at 828-754-3781 after submitting your application.

There are now two ways to pay your Entry Fee: 1. Mail a money order to Bethel Colony of Mercy, 1675 Bethel Colony Rd., Lenoir, NC 28645. If you are paying by money order please make sure you write the applicant's name on the "For" line. or 2. Pay your Entry Fee online. There is an additional non-refundable fee for the online payment of your Entry Fee.