Start WISE Process HERE Please complete this form to initiate the WISE process. Upon completion, a member of the WISE Team will reach out to you. This form does not certify your congregation, association, conference, or organization as WISE.Please enable JavaScript in your browser to complete this form.United Church of Christ Mental Health Network On behalf of the board, we want to thank you for your ongoing commitment to advocating for mental health, those living with mental health challenges, and their loved one. WISE Team board members that will be part of this team are Vicki K. Harvey, Psy.D., Jon Gilbert Martinez, M.Div., and Rev. Amy Petré Hill, JD. You may reach any of us at wise@mhn-ucc.org. Congregation's Name *Denomination *Please enter what denomination you are part of.Association or Presbytery *Conference *Please enter the name of your conference. If you do not have one, please type "NA."Faith Leader's Name *Please include the title: Rev., Rev. Dr., Rabbi, etc.Faith Leader's Call *InterimSettledLay-ledOtherHave you had a conversation with your faith leader and or your church council? *YesNoCongregation's Phone Number *No personal phone numbers.What is the best email address to use to reach your congregation? *EmailConfirm EmailWebsite / URL *If you do not utilize a website, please enter N/A.Congregation's Physical & Mailing Address *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeUse Address Line 1 for Physical Address; Use Address Line 2 for Mailing AddressDoes your congregation utilize any social media platforms for digital outreach? *YesNoNot at this time.List any social media links you use.Please enter your Facebook page address. Use a comma to separate multiple links.Do any of the following describe your congregation? Please select ALL that apply. *A2AOpen & AffirmingWhole EarthPeace & JusticeImmigrant Welcoming CongregationImmigrant SanctuaryOtherNot at this time.OtherPlease provide details for your response, "Other."If any of the above DO NOT apply to your congregation, have you begun conversation(s) on any of them? If so, which one(s)?Please be as specific as possible.What are you congregation's demographics? *White, Black, Latinx, Asian, Multi-cultural, otherWhat are you congregation's mental health demographics? *Do you have individuals or families in your congregation open about living with mental health challenges, substance use disorders, brain disorders, or neurodevelopmental differences in your congregation? On your WISE Team?Do you have a layperson leading your WISE ministry? *YesNoMany congregations have a lay leader helping lead their WISE congregation aside from their faith leader.Lay Leader's First Name *Who is the lay leader serving as the main contact for your WISE ministry?Lay Leader's Last Name *Who is the lay leader serving as the main contact for your WISE ministry?Phone *Zip Code *Enter your home zip code.Email *EmailConfirm EmailWhat have you done so far for your WISE journey? *Please be as specific as possible.What new programs, ministries around mental health do you envision developing as you respond to the evolving needs of your congregation? *Please be as specific as possible.Do you approve of being added to our UCC MHN newsletter? *YesNoNewsletter SignupEmailSubmit