Community Collaboration Request Form

Community Collaboration Request Form

Thank you for your interest in having Impulse Group DC collaborate, sponsor, table, or activate at your event. Please complete this form with as much detail as possible so our team can properly review your request. Collaboration and sponsorship requests must be submitted at least 60 days in advance. Resource tabling requests must be submitted at least two weeks before the event date to allow time for review, approval, planning, and coordination.
Applicant Name

First NameLast Name
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email
example@example.com
Organization Name (if applicable)
Social Media Handles
Tell us about yourself or your organization
Date of Event

MonthDayYear
Date
Title of Event
Purpose of Event
Which Impulse Group DC pillar aligns with this event?
Is this an in-person or virtual event?
Event Venue and Location
Event Start Time
Arrival / Setup Time
Anticipated Number of Guests
What are the demographics of your targeted audience for this event?
Will there be an admission fee for this event?
How will the event be marketed?
Would you like HIV/STI testing and/or other screenings to be provided at your event?
What type of support are you requesting from Impulse Group DC?

Other
What is the amount of funding you are requesting from Impulse DC? (Please use N/A if there is no funding request)
Elaborate on the role you envision for Impulse DC in your event
What will Impulse Group DC receive in exchange for partnership or sponsorship?
Examples: logo placement, social media mentions, speaking opportunity, vendor table, tickets, email inclusion, stage acknowledgment, etc.
Please upload any additional information, documents, files, proposals, or other materials related to your event.

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