Interested in donating to IMOS? Click here to learn more!
 
 

IMOS Logo


Forms and Documents

 
 

IMOS Forms

- Online Death Reporting (Brother or Widow)

-  Matching Grant Application - Lodges Only

Instructions for Completing Application for Assistance

- Application for Assistance

- Appeal Form

- Widow Assistance

State of Illinois

- Online application for Extra Help Program

- Illinois Cares Rx Online Application IL-1363 Online Form

- BenefitsCheckUp Online

For assistance completing any of the forms above contact:

Talia J. Dean, MA, LCPC 
Director of Outreach Services
Grand Lodge of Illinois
2866 Via Verde    
Springfield, Illinois 62703 
Phone: 217-529-8900- ext 212    
Fax: 217-529-0242