Winnebago County Community
Mental Health Board
Email Signup
*
indicates required
Name:
Email:
Comment:
Email Address
*
First Name
*
Last Name
*
Zip code
Phone Number
(
)
-
Organization or Community Member
Self-Identifies Category (Select all that Apply)
Winnebago County Residents
Advocate for Mental Health and/or Substance Use Disorder
Individuals with Mental Health and/or Substance Use Disorder
Family of Individuals with Mental Health and/or Substance Use Disorder
Students or adolescents
General Community Leaders: religions, non-profit, grassroots, neighborhoods, educational, and other
Public Official
County Board
Business Owner/Leader
Top Level Administrator
Clinician and/or Practitioner
Amount of Email you would like to receive
All
Only Major Updates
Grant Updates
Preferred format
HTML
Plain-text