Pre Release Assessment | TCBIN Re-Entry & Workforce Ln leade

TCBIN Next Level Living Community — Pre-Release Assessment & Transitional Housing Application

TCBIN NEXT LEVEL LIVING COMMUNITY

In Partnership with Ministry of Compassion

The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Comprehensive 60-Day Pre-Release Assessment
& Transitional Housing Application

A community built on accountability, leadership, growth, opportunity, and success.

"Turning Setbacks into Comebacks."

SECTION 1: IDENTIFICATION

Full Legal Name:

DC Number:

Email Address:

Institution:

Dorm/Housing Assignment:

Date of Birth:

Age:

Release Date:

County of Release:

State of Release:

Classification Officer:

Release Officer:

Probation Officer (if assigned):

Community Control:

Ethnicity:

Sex Offender Registration Required?: Yes No

Veteran Status:

Social Security Number Available?: Yes No

SECTION 2: RELEASE DESTINATION

Full Address:

City:

County:

State:

Zip:

Who owns the residence?:

Relationship to you:

Phone Number:

Have they agreed to let you stay there?

□ Yes □ No □ Unsure

SECTION 3: HOUSING RISK ASSESSMENT

Are you currently homeless upon release?: Yes No

Have you ever been homeless?: Yes No

Do you need transitional housing?: Yes No

Willing to participate in a structured housing program?: Yes No

Would you agree to:

□ House Rules□ Employment Requirements□ Drug Testing□ Curfew□ Community Service□ Leadership Development□ Financial Literacy□ Mentorship

↓ Read the full Next Level Living Community House Rules below, then check each agreement above ↓

Next Level Living Community — House Rules

TCBIN · In Partnership with Ministry of Compassion · HouseLink™

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Agreements

House RulesEmployment RequirementsDrug TestingCurfewCommunity ServiceLeadership DevelopmentFinancial LiteracyMentorship

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Residency Status & Program Participation / Mailing Address

Residency is conditioned upon compliance with all program rules. This is a drug-free and alcohol-free environment. These documents do not create a landlord-tenant relationship. Residents may use the residence address while enrolled. Upon discharge, residents must immediately update their mailing address with USPS and all agencies. Next Level Living Community is not responsible for forwarding mail after departure.

Security Cameras

Residents are strictly prohibited from covering, disconnecting, tampering with, or obstructing any security cameras on the property.

No Weapons

Possession of weapons, firearms, explosives, or dangerous items of any kind is strictly prohibited.

No Smoking / Vaping

Smoking, vaping, use of e-cigarettes, tobacco products, dips, or similar substances are prohibited inside the residence.

No Unauthorized Visitors

Visitors are not permitted inside the residence without approval from Next Level Living Community staff.

No Alcohol or Drugs

The use or possession of alcohol, illegal drugs, drug paraphernalia, or unauthorized prescription medication is strictly prohibited.

Medications

All medications must be legally prescribed and taken only as directed by a licensed physician.

Drug & Alcohol Testing

Random drug and alcohol testing may be conducted during residency.

Substance Abuse Referrals & Notifications

Residents may be referred to treatment programs if requested. In cases of violations, suspected substance use, or safety incidents, the resident's supervising officer or referral source may be notified immediately.

No Violence or Threats

Threats, violence, fighting, intimidation, harassment, or verbal abuse will not be tolerated.

Quiet Hours & Curfew

Sunday–Thursday: 10:30 PM–6:00 AM. Friday–Saturday: 12:00 AM–8:00 AM. We understand that work schedules, appointments, and life happen — if you need a curfew adjustment or extension, just talk to your house assistant or staff. Requests are reviewed on a case-by-case basis. This is a community, not a lockdown — communicate with us and we'll work with you.

Program Attendance

Attendance and participation in all required programs and meetings are mandatory.

Supervision Disclosure

Residents must provide probation, parole, or legal supervision information during intake.

Respect Others' Privacy & Property

Residents must respect the privacy and property of others.

No Theft

Theft of any kind is grounds for immediate discharge.

Hygiene & Cleanliness

Residents are expected to maintain proper hygiene and cleanliness.

No Food in Bedrooms

No food or beverages are allowed in bedrooms.

Shared Space Cleaning

Residents are responsible for cleaning shared spaces after use.

Label Personal Items

All food and personal items stored in shared spaces must be clearly labeled.

Prohibited Conduct

Gambling, pornography, sexual activity, or sexually inappropriate conduct is prohibited.

Door Codes Confidential

Door codes are confidential and may not be shared.

No Unauthorized Access

Unauthorized access to restricted areas is prohibited.

Room Inspections — At Any Time

Staff or any team member may enter and look in your room at any time, without prior notice, to ensure the home is being maintained and that everyone is doing their part. This is not to invade your privacy — it is to keep the home clean, safe, and accountable for everyone.

Laundry Hours

Laundry must be completed during reasonable hours.

Damage Responsibility

Residents are financially responsible for damages caused by themselves or guests.

Property Maintenance

Residents may be asked to assist in maintaining a clean and safe property.

Personal Storage

Lockers are available for personal storage for a monthly fee of $5.

Vacate Upon Exit

Residents must vacate the property once program funding or approved residency has ended.

Emergencies

In emergencies, residents should call 911 immediately and notify staff as soon as possible.

Business Hours & Staff Contact

Business hours: Mon–Thu 9:00 AM–5:00 PM, Fri 9:00 AM–2:00 PM. Residents will be assigned a house assistant for routine matters. Contact staff — not property owners — for non-emergency issues. Call 911 for emergencies.

Agreement

By signing, residents acknowledge they have read, understand, and agree to comply with all Next Level Living Community house rules and program policies.

Clean Up Behind Yourself — Every Day

Every resident is responsible for cleaning up behind themselves on a daily basis. This means washing your own dishes immediately after use, wiping down any counter or table you use, and keeping your personal belongings in your assigned space. This is a daily personal responsibility for every resident and is separate from the weekly zone assignments.

Weekly Cleaning Schedule & Zone Rotation

Shared cleaning duties are divided into four rotating zones: (1) Kitchen Area, (2) Bathroom Area, (3) Common Area / Living Room, and (4) Whole House Cleanliness Check. Each resident is assigned a zone for the full week, and assignments rotate every Monday so that duties are shared fairly. The current week's assignments are posted on the Cleaning Schedule and the House Responsibilities Guide.

Community Service Requirement

Any resident who does not hold a permanent job is required to complete a minimum of 10 hours of community service per week. Residents who are employed must complete 3 to 5 hours of community service per week, depending on their work schedule. Community service hours must be logged and verified. This requirement remains in effect for the duration of residency.

Job Readiness & 30-Day Employment Requirement

Upon entering the facility, every resident is expected to actively pursue employment. Residents who do not have a permanent job at the time of intake have 30 days from their admission date to secure employment. If a resident is not employed by the end of the 30-day period, a special review will be conducted by program staff to evaluate the resident's progress, efforts, and circumstances. A resident may submit a written request to staff for one additional 15-day extension before the 30-day deadline expires. If employment has not been secured by the end of any approved extension, a further review will take place to determine whether relocation from the program is necessary. Continued residency is contingent on demonstrated, documented job-search effort and participation in job-readiness activities.

Mandatory Response to Staff, Program Director & Facility Owners

Residents must respond or reply to all communications from staff, the program director, and facility owners. Failure to do so may result in removal from the program.

Sign-In / Sign-Out Required

Residents must sign in and out every time they enter or leave the residence. No leaving without signing out. If a resident is advised multiple times about failing to sign in or out, they may be subject to removal from the program.

Resident Acknowledgment — Sign Below

Type your full legal name as your digital signature

By typing your name above, you acknowledge you have read, understand, and agree to comply with all Next Level Living Community House Rules.

Date

By signing, the resident acknowledges they have read, understand, and agree to comply with all Next Level Living Community House Rules.

↓ Read the Participant Intake, Administration & Residence Payment Agreement below, then acknowledge and sign ↓

Participant Intake, Administration & Residence Payment Agreement

Post-Acceptance Participant Agreement · Completed after acceptance and before move-in

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Acknowledgments

Participant Information

Participant Full Legal Name

DC Number

Release Date

Expected Move-In Date

Facility / Institution

Employment Start Date

Employer

Current Pay Frequency

TCBIN Next Level Living Community·In Partnership with Ministry of Compassion·The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Mandatory Intake & Administration Fee

$279.00due before move-in

This fee supports intake processing, program enrollment, initial paperwork, move-in coordination, arrival assistance, basic food and immediate-needs coordination, and initial case planning and referrals. It is separate from monthly residence payments and is not a security deposit.

Payment Status

Amount Paid Today ($)

Remaining Balance ($)

Payment Date

Approved Due Date

Payment Method

Intake Fee Paid in Full

TCBIN Next Level Living Community·In Partnership with Ministry of Compassion·The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Residence Admission Payment

$850.00

Participants who have been employed and receiving income for 30 days or longer are expected to pay the full $850.00 residence admission payment before move-in. Participants employed for less than 30 days are expected to pay the mandatory $279.00 intake fee and at least one-half of the residence admission payment ($425.00) before move-in, with the remaining $425.00 due under a written payment schedule.

Participants who are unemployed or experiencing verified financial hardship may request a written modification or installment arrangement. Assistance is not automatic. Any delayed, reduced, or divided payment must be approved in writing by authorized program leadership before move-in.

Participant Payment Category

Residence Amount Paid Today ($)

Residence Balance ($)

Next Payment Amount ($)

Next Payment Due Date

Payment Date

Residence Admission Paid in Full

Approved Payment Schedule & Conditions

Hardship Modification Approved

TCBIN Next Level Living Community·In Partnership with Ministry of Compassion·The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Monthly Residence Payment — Ministry of Compassion Inc.

Monthly residence payments are made to Ministry of Compassion Inc. unless written instructions state otherwise. The participant must include their full name and payment month in the payment memo.

RecipientMinistry of Compassion Inc.

BankWells Fargo

Account Number7904281206

ZelleMinofcompass@gmail.com

Payment PurposeMonthly residence payment

TCBIN Next Level Living Community·In Partnership with Ministry of Compassion·The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Intake / Admin Fee Payment — The Comeback Initiative Network LLC

The $279.00 intake and administration fee is paid to The Comeback Initiative Network LLC. The participant must include their full name in the payment memo.

RecipientTCBIN LLC

ACH Account #1100042018188

ACH Routing #263191387

Cash App$mjtcbinetwork

Zelle / Apple Pay407-757-7029

Payment PurposeIntake and administration fee

TCBIN Next Level Living Community·In Partnership with Ministry of Compassion·The Comeback Initiative Network Re-Entry Workforce & Leadership Development Inc.

Participant Acknowledgment

I understand that acceptance into the program does not eliminate my responsibility to pay approved intake, admission, and residence charges.I understand that participants with available employment income or other financial resources are expected to contribute toward program and residence costs.I understand that no verbal promise changes this agreement. Any exception or payment modification must be written and approved by authorized leadership.I agree to keep receipts or electronic payment confirmations and provide proof of payment when requested.I understand that failure to follow an approved payment arrangement may affect continued program participation, and subject to program review and applicable law.

Signatures

Participant

Participant Signature (type full legal name)

Date

Phone Number

TCBIN Representative

Representative Printed Name

Representative Signature (type name)

Date

Ministry of Compassion Representative

Representative Printed Name

Representative Signature (type name)

Date

Participant must receive a completed copy of this agreement and a receipt for every payment.

Why are you seeking transitional housing?

SECTION 4: EMPLOYMENT READINESS

Do you currently have a job offer?: Yes No

Employer Name:

Employer Phone:

Position:

Start Date:

Hourly Rate:

Skills & Trades:

□ Construction□ Warehouse□ Forklift□ Manufacturing□ Landscaping□ Food Service□ Hospitality□ Sales□ Customer Service□ Maintenance□ HVAC□ Plumbing□ Electrical□ Entrepreneur□ Other

Would you accept Second Chance Employment?: Yes No

Do you need:

□ Resume□ Interview Coaching□ Job Placement□ Trade Training□ Apprenticeship

Employment Retention Tracking (Staff Review / Post-Program)

Retained Employment at 30 Days?

□ Yes □ No □ Pending □ N/A

Retained Employment at 90 Days?

□ Yes □ No □ Pending □ N/A

Retained Employment at 180 Days?

□ Yes □ No □ Pending □ N/A

Employment Retention Notes:

SECTION 5: FAMILY & SUPPORT SYSTEM

Marital Status:

Children? (Y/N):

Number of Children:

Ages:

Do you have family support?

□ Strong □ Moderate □ Weak □ None

Primary Support Person (Name):

Phone:

Relationship:

Can you rely on this person?: Yes No

SECTION 6: LEGAL CONDITIONS

County of Supervision:

Special Conditions:

Curfew Restrictions:

Travel Restrictions:

Employment Requirements:

Financial Obligations:

Restitution:

Court Costs:

Child Support:

Outstanding Warrants?: Yes No

SECTION 7: TRANSPORTATION

Driver License Status:

□ Valid □ Suspended □ Revoked □ Never Licensed

Transportation Plan

SECTION 8: EDUCATION

Highest Education Completed:

GED: Yes No

High School Diploma: Yes No

Trade School:

College Credits:

Certificates Earned:

Current Educational Goal:

Currently Enrolled in Education?

□ Yes – Currently Enrolled □ No – Not Enrolled □ No – Completed □ N/A

SECTION 9: HEALTH & WELLNESS

Do you have medical conditions?: Yes No

Mental Health Services Needed?: Yes No

Substance Abuse History?: Yes No

Currently Receiving Treatment?: Yes No

Need Community Referrals?: Yes No

Healthcare Enrollment Date:

Primary Care Provider:

Healthcare Notes:

SECTION 10: FINANCIAL READINESS

Money Available Upon Release ($):

Savings:

Checking Account: Yes No

Cash App: Yes No

PayPal: Yes No

Bank Account: Yes No

Need Banking Assistance?: Yes No

Credit Building Assistance?: Yes No

Budgeting Assistance?: Yes No

SECTION 11: REENTRY READINESS SCORE

Rate yourself 1–10:

Housing Readiness /10:

Employment Readiness /10:

Family Support /10:

Transportation /10:

Financial Stability /10:

Personal Accountability /10:

Leadership Potential /10:

Motivation to Succeed /10:

SECTION 12: TCBIN TRANSITIONAL HOUSING ELIGIBILITY

Why should you be selected for a TCBIN housing opportunity?

What are your goals during your first 90 days?

What obstacles do you believe may prevent your success?

What strengths will help you succeed?

SECTION 13: 90-DAY SUCCESS PLAN

Within 30 Days I Will

Within 60 Days I Will

Within 90 Days I Will

SECTION 14: SOCIAL REINTEGRATION & COMMUNITY ENGAGEMENT

Community Engagement Activities (describe participation in community events, groups, faith-based activities, volunteer service...)

Volunteer / Community Service Hours Completed:

SECTION 15: RECIDIVISM & LEGAL STATUS TRACKING (Staff Review)

Date of Recidivism Event (if applicable):

Recidivism Details (charges, disposition, court dates, impact on program participation...)

SECTION 16: DISCHARGE & POST-DISCHARGE LONGITUDINAL TRACKING (Staff Review)

Discharge Date:

Discharge Notes

Self-Sufficient Upon Discharge?

□ Yes – Living Independently □ Yes – With Family/Friends □ No – Transitional Housing □ No – Shelter/Homeless □ N/A – Still Active

Post-Discharge Follow-Up (6 Months – 5 Years)

Post-Discharge Notes / Longitudinal Updates

SIGNATURE & CERTIFICATION — Required Before Submission

How is this assessment being completed?

□ Self-Completed by Applicant □ TCBIN Staff on Behalf of Applicant

By signing below, I certify that all information provided in this assessment is accurate and truthful to the best of my knowledge. I understand this document will be used to support my reentry planning and transitional housing eligibility review with TCBIN Next Level Living Community in Partnership with Ministry of Compassion.

✍️ Draw your signature above using your finger or mouse

Printed Name:

Date: 9/29/2026

STAFF REVIEW SECTION (Institutional Use Only)

Housing Candidate: Yes No

Employment Ready: Yes No

Risk Level:

□ High Risk □ Moderate Risk □ Low Risk

Leadership Academy Candidate: Yes No

Mentorship Candidate: Yes No

Immediate Housing Need: Yes No

Immediate Employment Need: Yes No

Recommended Action Plan

Reviewer Name:

Date:

Signature:

TCBIN Institutional Leadership Academy | The Comeback Initiative Network | "Resilience is my slogan. Turning Setbacks Into Comebacks."