Donation and Sponsorship Request

Donation and Sponsorship Request
Date of Request*
Event/Program Requesting Support
Date of Event*

MonthDayYear
Date
Date Support Needed*

MonthDayYear
Date
Location of Event (city and facility)*
Support Requested (attach all sponsorship info)*
File Upload

Cancelof
Briefly Summarize Event/Program*
Visibility for Memorial Hospital and Health Care Center (ad, banner, web, handouts, What is included for the sponsor?):
Number Expected to Attend
Deadline for Deliverables
Organization*
Contact Name*
Title
Email*
example@example.com
Daytime Phone
Mailing Address
Your Organization's For Profit/Non-profit Status
Years in Operation
Have you received a sponsorship from Memorial Hospital and Health Care Center in the past? If yes, please list amount(s) and date(s) and a brief description of sponsorship and event/program.
Additional information you would like to provide:Please include/attach any supporting documentation about your event/program, promotional materials, etc.
You will receive correspondence from Memorial Hospital and Health Care Center with our decision by email. For additional questions regarding this process, please contact our Donations Committee at donationrequests@mhhcc.org.
Should be Empty: