Wellness Hub Membership Application

The MWWHub exist to address holistic health across many dimensions of wellness to address health disparities and wellness needs faced by West Chicago residents. We are a trusted gathering place that connects individuals and families within the community to essential programs, services and spaces that advance health equity, improve health outcomes and enhance quality of life.
* Organization or Individual: Legal Name
0/50
* Organization Type
0/250
* Executive Director/CEO: Name
0/50
* Executive Director/CEO: Phone Number
0/50
* Executive Director/CEO: Email
0/50
* Description of Religious or Faith-Based Institution if any. (type n/a if not applicable)
0/50
* Description of Institution of Higher Learning and services provided if any. (type n/a if not applicable)
0/250
* Description of Community Organizing Entity and activities if any. (type n/a if not applicable)
0/250
* Please check all of the communities your organization currently provides services:
0/250
* Please Identify the wellness areas to which you intend to engage Westside individuals and families in through your membership with the Hub:
0/250
* Please provide a brief description of how you will engage people in these wellness areas
0/500
* I am interested in engaging the Hub through the following (check all that apply)
0/250
* What is your organizational budget?
0/50
Submit Application
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