Health & Human Services

Contact Us

Health and Human Services
General Inquiries

P: 847.391.5480
1420 Miner Street
Des Plaines, IL  60016

Office Hours
Monday to Friday
8:30 am to 5:00 pm

About Us

The City's Health and Human Services (HHS) Division is in place to help promote the health and well-being of Des Plaines residents through information/referral on programs and services available to community members. 

Located at City Hall, 1420 Miner Street, the Community Social Worker is available Monday through Friday, from 8:30 am to 5:00 pm. Please contact HHS with any concerns or questions you have regarding health and social issues for yourself or loved ones in the City. If the Division does not provide a particular service, we will connect you with someone who does.

2020 Social Service Funding Application

Application and supporting materials must be received by 5:00pm on Friday, February 28, 2020 to be considered.

  • Please use this computer generated form.
  • Completed application should be submitted online.
  • Form must be printed for your records before you submit the application.

This form does not have a "Save Draft" function. It is highly recommended that your answers be created in a text document, and then copied and pasted into this form.

SECTION A
Agency Information







SECTION B
Main contact person for this application and program. Please list information for the person to be contacted regarding this application.










SECTION C
Current Funding Request Information



Children
People with Developmental Disabilities
People with Physical Disabilities
People with Mental Health Issues
People with Substance Abuse Issues
Seniors
Low Income
Other (please list below)



SECTION D
Checklist for required documents and Certification of Information

Required Supplemental Materials Checklist 

Please be sure that your application includes copies of the documents listed below.

Check the boxes below to indicate that the materials required are included.

Failure to include these documents may result in denial of this application.

You may attach the documents below or send them to either HHS@desplaines.org  or fax to 847.827.2292.



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Proof of non-profit status (i.e., letter of tax-exempt status from the Illinois Department of Revenue)W-9 FormMost recent Annual ReportProgram Budget

Certification of Information

I certify that the information provided is true to the best of my knowledge and the agency I represent is in good standing with the State of Illinois. I am also aware that this information is subject to review and verification and I may have to provide documents to support this application. I am also aware that any misstatements or false facts could result in denial of the application.


*indicates required fields.