To be completed by the student:

Substance abuse and/or psychiatric treatment history (dates and duration):

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How long have you been sober and in recovery?

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Please describe your level of motivation and commitment to recovery?

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Please print both pages.  Complete the application for admission.and return to:

Michelle Lipinski, Director
Northshore Recovery High School
502 Cabot Street
Beverly, MA 01915                                    

phone: 978.232.9755 ext. 1949
Fax: 978.232.9449
mlipinski@nsedu.org