2025 Sponsorship Form

2026 Sponsorship Form

Please join us on March 28, 2026 from 5:00 p.m. to 8:00 p.m. as we celebrate the 23rd Annual F.W. Huston Medical Center Spring Fundraiser. The event is located at 302 5th Street, Winchester, KS 66097. We look forward to seeing you!
Event Sponsor's Name
(Business, Organization or Individual)
Name of Contact Person*

First NameLast Name
Title
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please select the sponsorship level that best aligns with your support:*

100 Square Feet - $5,00050 Square Feet - $2,50025 Square Feet - $1,00010 Square Feet - $5005 Square Feet - $200Other
Please provide a high-resolution company logo for inclusion in event materials.

Cancelof

Payment Information*

USDAmount

Additional Comments or Requests:
Sponsor Agreement:

By submitting this form, the sponsor agrees to the terms outlined in the sponsorship levels and commits to providing the selected sponsorship amount by [Payment Deadline]. The organizer reserves the right to allocate benefits based on the sponsorship level and payment received.
Authorized Signature: *
Date Signed*

MonthDayYear
Date
Should be Empty:

2026 Sponsorship Form