The Help Enrich African American Lives (HEAAL) coalition promotes a community that embodies every aspect of health and wellness in all communities. Mission: To enrich the quality of African American Lives through community engagement and collaboration. To identify needs and develop prevention strategies that support healthy decision making for better lifestyle outcomes.
I agree with the mission and vision of the HEAAL Coalition and its commitment to reducing substance abuse among youth by increasing collaboration and coordination of community services and resources. I support this mission to create population level change by participating with the HEAAL Coalition, attending meetings as available, participating in Coalition initiatives and assisting with ongoing assessment, planning, sustainability and implementation of Coalition initiatives.
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Organization
Email
example@example.com
Please Identify your coalition sector and /or the community you represent
Youth (under 18)
Youth Serving Organization
Healthcare Professional
Schools
Faith Based
Civic Volunteer
Law Enforcment
Business
Media
Parents
Local Gov't
Other:_________
Please indicate resources or services that you or your organization can provide for the coalition(check all that apply)
Hosting or sponsoring a Coalition meeting or event at your facility
Professional training for Coalition members
Education presentation for Coalition and community Topics
Advertising for Coalition events within the community
Fundraising
Providing volunteers to assist with Coalition events
Event Organization
Printing or Photocopying of Coalition materials
Marketing / Social Media
I am interested in assisting the Coalition the following activities
Strategic Planning
Community Fairs / Events
Marketing / Social Media
Data Collection
Community Forums
Youth Engagement
Coalition Governance
Workshops / Presentations
Capacity Building
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Submit
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