2. 
4. NEW ORGANIZATIONS - Request to be included in next edition
6. Name of Organization/Business*
8. Address*
10. City*
12. State*
14. Zip Code*
16. County of business address*
18. Phone Number*
20. Website link
22. Category to be included in*
    -- Select One --Disability ServicesFood ResourcesHealthcare ServicesHousing & ShelterLegal ServicesPublic Assistance & UtilitiesRecreation, Protection & EntertainmentTransportation ServicesVeteran ResourcesWorkforce & Education
24. Counties of services*

    1. DuPage
    2. Kane
    3. Kendall
    4. Will
26. List top five senior services offered:*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field