Community Liaison Contact Form
Please fill out the brief informational form and City of Charlestown Community Liaison, Courtney Rodewig, will reach out to provide guidance. Courtney is available at City Hall on Thursdays from 9 a.m. to 1:30 p.m. and Fridays by appointment only. To reach Courtney's office by phone, please call 812-256-3422 or email socialworker@cityofcharlestown.com. In case of emergency, call 911.
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Circle all the needs/areas/categories you may need the community liaison for:
*
Housing/Shelter
Food/Clothing/Household Items
School Issues/Placement/Testing
Medical Needs
Psychological Concerns
Substance Abuse/Treatment Issues
Legal Issues
Therapy Servicies
Financial Assistance
Religious Needs
Language Barriers/Communication
Childcare
Transportation
Other
Option: Please explain client needs/wants
Submit
Should be Empty: