Dear Applicant,


    Thank you for your interest in becoming a participant at Churchill’s Lighthouse Inc. We are honored that you are seeking a safe, supportive, and nurturing environment during this important season of your life. Our mission is to provide housing, resources, and spiritual guidance for young women who are preparing to embrace motherhood for the very first time.


    To ensure that we are able to serve you in the best way possible, please carefully review the following requirements for participation:

    • First-Time Mom – Applicants must be expecting or have recently given birth to their first child.

    • Age Requirement – Applicants must be between the ages of 18 and 30 at the time of admission.

    • Background Check – A clean background check is required prior to acceptance into the program.


    If you meet these requirements and feel that Churchill’s Lighthouse is the right place for you, we invite you to complete the application and return it along with the necessary documents. Once your application is reviewed, our team will contact you to schedule an interview and discuss the next steps.


    We look forward to walking alongside you on your journey and providing the care, guidance, and resources you need to thrive as a mother and woman of purpose.

    With care,

    Mrs. Sherri Churchill

    Executive Director

    Churchill’s Lighthouse Inc.



    Applicant Information












    Pregnancy Information


    Are you a first-time mom? (Required)

    YesNo




    Eligibility Confirmation


    Age Requirement (18–30) (Required)

    YesNo


    Background Check (clean record) (Required)

    YesNo


    Emergency Contact





    Personal Background



    Employment Status (Required)

    EmployedUnemployedStudent


    Do you have a support system (family/friends)? (Required)

    YesNo



    Faith & Support


    Do you have a church home? (Required)

    YesNo


    Interested in faith-based support services? (Required)

    YesNo


    Signature & Acknowledgement





    Optional Uploads (Documents)



    Questions? Email info@churchillslighthouse.org or call (502) 632-3487.