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
Which SHIP priority areas or workgroups is your organization interested in learning more about or participating in?
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

My Products*

My Products