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Community Mentoring Request Form

Estimated time: 2 minutes

1. Tell us about yourself:

2. Illinois County and City you work in:*

3. What are you hoping to accomplish?

Select all that apply:

4. Tell Us More:

Thank you! Your submission has been received!
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We’re Here for You.

Our team will review your request and follow up within 3 business days.

We'll reach out to learn more and understand your goals.

Together, we'll turn your ideas into action to strengthen your community.

Community change is
powered by you,
and supported by us. 

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The Center for Community Engagement is funded in full or in part through a State Opioid Response Grant (TI085769) to the Illinois Department of Human Services, Division of Behavioral Health and Recovery, from the U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration. 

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