Partner Interest Survey
Let us know about your organization, interests, and ways we can collaborate to support our community.
Organization Type
Community Organization
Business
Government/Public Agency
School/Educational Institution
Healthcare Provider
Nonprofit/Service Provider
Faith-Based Organization
Other
What services, programs, or resources does your organization provide?
Community Needs/Populations Served
Children & Youth
Families
Adults
Older Adults
Individuals Experiencing Homelessness
Individuals/Families Experiencing Financial Challenges
Other
Partnership Interests
Share Resources & Referrals
Participate in Community Events
Provide Education or Training
Support Outreach
Provide Services or Resources
Collaborate on Community Programs
Other
What community health or social issues are you most interested in addressing?
What resources, expertise, or opportunities could your organization contribute?
Organization
Contact Name
Email
example@example.com
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Is there anything else you would like us to know about your organization or your interest in partnering with Illinois C.A.R.E.S.™?
Submit
Should be Empty: