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.

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 no, GED? Yes







YesNo
NOTE:(Must be detoxed at least 5-7 days) If you come in requiring detox, you will 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

YesNo


NOTE:  If you are a felon you must send a copy of your Criminal Record. If you choose to stay in the Lenoir area when you leave Bethel, we may notify the local authorities. We require that all outstanding legal issues be addressed before entering our program or be postponed until you have completed the program.

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 and at specified times only.  Cigarettes only; - vapes, e-cigs, roll your own or any other form of tobacco are not allowed.

You are responsible for your own cigarettes and we will not take responsibility for providing those for you or replacing any that are misplaced.

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, paper towels, and laundry detergent when you check-in to Bethel.

There is also a $10.00 drug-screening fee when you check in to Bethel. After that, any time you have a visit you will be required to pay a $10.00 fee before you leave on your visit to cover a drug screening upon your return.

5. HEALTH AND RELATED ISSUES.....

GoodFairPoor

YesNo











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

PLEASE HAVE ALL PRESCRIPTION MEDICATIONS FILLED BEFORE COMING as well as ALL NEEDED REFILLS FOR THE 65 DAY PROGRAM.







YesNo





YesNo

Send a doctor's letter confirming your current status.

If Hep C - you will need a doctor's letter stating you will not need treatment while at Bethel.

YesNo



If yes, you will need a doctor's letter stating you have been cleared and no further signs are evident.

YesNo



YesNo


DiabetesEmphysemaHeart ProblemsHigh Blood PressureHypoglycemia

YesNo



8. For a detailed list of what you will need to bring and what is not allowed click here.   These are the items you will need:

- Bring work and dress clothes Some that are not allowed are: no words or photos with drugs, tobacco, alcohol, or anything contrary to a Christian lifestyle; no tight fitting pants without a long top covering them; no low cut tops. No spaghetti straps; no short-shorts.
- Bring your own washcloths, towels, and pillows. (mark your name on them). Bed linens are provided.
- Bring your own personal toiletry items (nothing with alcohol, ie; mouthwash, colognes, or aerosols)
- Bring a cloth mesh 36 x 24 laundry bag. (Can be purchased at Wal-Mart.)
- Vitamins which are new with the seal unbroken.
- Napkins, toilet tissue, paper towels, facial tissues, laundry detergent, and feminine hygiene products.
- Bring a Bible if you have one.


These are the items that are NOT allowed:

- NO BODY PIERCING RINGS OR STUDS WORN ANYWHERE ON YOUR BODY!!
- No audio or video apparatus: CDs, DVDs, MP3, IPods, Video Games, etc.
- No over the counter medications.
- No caffeinated drinks, coffee, or pills.
- No provocative clothing either daily wear or sleep wear.
- NO cell phones.



YesNo     YesNo

Yes (required)


I HAVE READ THIS ENTIRE APPLICATION AND AGREE TO FOLLOW ALL THE GUIDELINES SET IN PLACE BY BETHEL COLONY OF MERCY. BY SIGNING, I PROCLAIM I HAVE ANSWERED HONESTLY TO THE BEST OF MY ABILITY. I UNDERSTAND ANY ANSWERS GIVEN WHICH ARE FOUND TO BE INACCURATE MAY BE REASON FOR ME TO BE ASED TO LEAVE THE FACILITY.

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.

There are now two ways to pay your Entry Fee:
1. Mail a money order to Bethel Colony of Mercy, 1181 Camp Carolwood Road, Lenoir, NC 28645. If you are paying by money order please make sure you write the applicant's name on the "For" line.
2. Pay your Entry Fee online. There is an additional non-refundable fee for the online payment of your Entry Fee.