2026 Alliance Membership & Sponsorship Form

2026 Alliance Membership & Sponsorship Form
Are you a new member or existing Alliance member?*
Name and Email of the Person Completing This Form*
How did you find out about the Alliance?*
Organization Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Organizational Mission:*
Organization website:*
Organization logo:*

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Representatives
Senior Leader Representative #1*

First NameLast Name
Title*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Senior Leader Representative #2*

First NameLast Name
Title*
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Communication/Marketing Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
Billing Contact*

First NameLast Name
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email*
example@example.com
My Products*
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PLATINUM MEMBERSHIP LEVEL
Includes Title Level Sponsorship for the 2026 Health for All Summit and 9th Annual Live Healthy SC Conference

$15,000



GOLD MEMBERSHIP LEVEL
Includes Premier Level Sponsorship for the 2026 Health for All Summit and 9th Annual Live Healthy SC Conference

$10,000



SILVER MEMBERSHIP LEVEL
Includes Supporter Level Sponsorship for the 2026 Health for All Summit and 9th Annual Live Healthy SC Conference

$5,000



BRONZE MEMBERSHIP LEVEL
$2,000



ADD ON: 2026 Health for All Summit Sponsorship
Bronze Members Only

$10,000
Item subtotal:$0.00



ADD ON: 9th Annual Live Healthy SC Conference Sponsorship
Bronze Members Only

$10,000
Item subtotal:$0.00



Total

$0.00
Chronic Health ConditionsBehavioral & Mental HealthMaternal & Infant HealthAffordable & Nutritious FoodsSafe & Affordable Places to be Physically ActiveEducationIncome & PovertyAccess to High Quality CareNeighborhood & Community Development
What support, resources, or connections would be most helpful to your organization this year?*
Alliance Membership Commitments

Leadership Engagement: Ensure active participation by senior leadership (e.g., CEO, Executive Director, or other executive leaders) to drive strategic discussions and decision-making.

Support Live Healthy SC Priorities: Commit to advancing the State Health Improvement Plan by aligning organizational efforts with the Live Healthy SC priorities and contributing to measurable health improvements for South Carolinians.

Financial Partnership: Provide monetary contributions to support the Alliance’s operations and initiatives, enabling collective efforts to convene stakeholders, connect resources, and catalyze impactful change statewide.

Collaborative Action: Actively engage in initiatives that embody the Alliance’s collective vision, working with partners to avoid duplication, maximize resources, and promote equity-driven solutions.

Accountability and Alignment: Share progress on organizational actions that support the Alliance’s collective agenda, ensuring transparency, alignment, and a unified approach to addressing South Carolina’s health challenge.
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2026 Alliance Membership & Sponsorship Form

Representatives