Teen Challenge of Mississippi 


​help for life-controlling problems



5 Buford Lane Poplarville, MS 39470   601.795.8063

Office hours: Monday - Friday: 9 am - 5 pm


To download the printable application for admission, click the link.


Application for Admission

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Check List:
Over-the-phone Interview
Completed Application (Application below, fax or mail pages 7-14)
General Rules Agreement (read pg. 4, fax or mail signature on pg. 7)
Student Agreement (read pg. 5, fax or mail signature sheet on pg. 7)
Health Screening (medical provider to fax lab results & complete pg 19, 20)
Medical and Dental Care up to date
Legal matters completed or on hold until leaving (
official letter required)
Bus Fare and a transportion fee
Identification (Driver’s License, Social Security Card, Military ID, etc.)
Fees (checks payable to Teen Challenge of MS, Inc.)
Student’s personal spending money
Student’s items & clothing (list of required/allowed items, pg. 3)


All checks are payable to Teen Challenge of Mississippi.