Behavioral Health Reentry Navigator Application

Behavioral Health Reentry Navigator
Please note, this is a volunteer position, but because of the nature of the role, it requires working closely with MCRC Staff to ensure those returning to McLean County have all the support and resources necessary to succeed. Please review the job description before applying.
Full Name

First NameMiddle NameLast Name
Current Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
How long have you lived in McLean County?
Email Address
example@example.com
Phone Number
Format: (000) 000-0000.
Birth Date

MonthDayYear

Background and Lived Experience
Have you been incarcerated?
If yes, how long were you incarcerated (in total)
Are you currently on parole or probation?
If no, have you experienced parole or probation? If so, when and how long?
Please briefly describe your incarceration experience, or how having a family member incarcerated affected you.

Community Involvement
Are you currently involved in the community?
Please describe your current or past community involvement. Include the organizations and how you were involved (organizations, volunteering, church, etc.)

Personal References
Please list two people that you have known for at least a year who can speak to your work ethic, character, and abilitly to successfully fulfil this postion.
Reference One

First NameLast Name
Reference One Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference One Email
example@example.com
Have you told them that we might contact them about your application?
Reference Two Name

First NameLast Name
Reference Two Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Reference Two Email
example@example.com
Have you told them that we might contact them about your application?

Signing below confirms that the questions included in this application are true to the best of your knowledge.
Signature
Thank you for taking the time to fill out the Behavioral Health Community Navigator application. We will review your application and contact you within 48 hours if we have more questions.
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Behavioral Health Reentry Navigator