Thank you for your interest in the Independence Network-NJ, a new supported independent living community starting in Collingswood, NJ. Please complete the form below, and we will be in touch with more information. First Name*Last Name*Phone Number*Email* Are You?*Potential ClientFamily or Friend of Potential ClientProfessional Seeking Referral InformationOtherHow did you hear about Independence Network?*GoogleFacebookNewspaperFriend or FamilyNewsletterReferral From Another OrganizationConferenceOtherAnything Else We Should Know?By submitting this form, I give JEVS Human Services consent to contact me using the above phone number and email address, and to use automated technology to call and text at the phone number above, including the wireless number if provided.
