Highland Neighborhood Service Integration Funding Request Form

Thank you for submitting your request for funding through the CBEL Highland Service Integration program.

Please take a minute to read through the form instructions. This information helps the coordination team better understand your request and prepare you to present your request to the team. Please take time to read and complete each field. The better we understand the request the quicker your request will be processed. You will receive an email confirmation that your request has been submitted by a member of the Service Integration coordination team and another email when the funding decision has been made by the team.

Funding requests need to be submitted by a service provider (i.e. - counselor, case worker, peer support specialist, etc.), who will be responsible for managing all client interactions related to the request.

If you are not a service provider, and do not have a service provider to complete this request on your behalf, please contact Jackie Franke at 503-999-2761.

If you have not received a confirmation email, please check your spam folder. If you can't find the confirmation email, please reach out to info@cbelsalem.org or call 503-893-0272.

If you need a copy of the Client Consent Form to submit in the form below, click here.