Southern Illinois Resource Guide Resource Submission Form
This survey is for submitting and updating resources to the Southern Illinois Resource Guide. Please fill out the form below with your organization's information. 

Please keep in mind that submitting this form does not guarantee a spot for your organization in the Resource Guide. We consider all submissions, but cannot promise that all submissions will be included.

Please include an updated email address so that we can contact you if we need more information.
Email *
I would like to... *
What is the name of your service or organization? *
What Illinois County is your organization located in? *
What counties does your organization provide services to? Please check all that apply.
If your organization services all counties, you can select "All". 
 *
Required
Please give a brief description of the service your organization provides. This will be used in the guide to help people understand what your organization does. 
For example, "Counseling, education, medical
and legal advocacy for domestic
violence" *
What is your organization's phone number? *
What is your organization's website or facebook page url? (please provide the full working url) 
Please tell us the best way to contact you about your organization's inclusion in the Southern Illinois Resource Guide. 
If it is through email or phone, please provide the email or phone number. 
Please tell us anything you want the community to know about your organization. 
For example, limited hours or business days, a specific name to contact, only available to certain demographics, etc. 
Space in the guide is limited, so please be as concise as possible.
Do you have any constructive feedback to help improve the Southern Illinois Resource Guide?
Submit
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