Sponsorship Requests

Organization

Address

City / State / Zip

Contact Person

Phone Number

Email

Is this organization designated as not-for-profit by the Internal Revenue Service? Yes No

Nature of Sponsorship Annual One-time Fundraising Event Health fair expo Lecture

What is the date of the event?

What is the type of contribution requested? Monetary Promotional Items Volunteers

Contribution Amount Requested

Attach document(s)