Tell us about you and your cause:
Date of Application
-
Month
-
Day
Year
Date
Applications must be submitted 60 days, ideally, prior to the event date or project start date.
Contact Name
*
First Name
Last Name
Primary Email
*
example@example.com
Primary Phone
-
Area Code
Phone Number
Mailing Address
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Is this event hosted by:
Sponsoring Club/Organization
Company
Individual planning the event
Club/Organization or Company Name
Organization or Company website:
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Share with us how money will be raised:
Name of philanthropic event or program
*
Describe your plans for the event/program
*
Date of event
*
-
Month
-
Day
Year
Date
Event Start Time
Event End Time
Event Location
Anticipated number of guests
Would you like to request a representative from the Baptist Health Foundation at your event?
Yes
No
What would the representative from the Baptist Health Foundation do at the event?
Check Presentation
Photo Opportunities
Speak about the Benefiting Hospital or Program
Total Anticipated Revenue (Gross)
Total Anticipated Expenses
Anticipated Net Revenue to Baptist Health Foundation
Please upload your list of individuals, businesses, or corporations you plan to solicit.
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Share more with us
Does your organization or the event have social media?
Yes
No
Facebook page name
Twitter handle
Instagram handle
Will you promote the event on social media?
Yes
No
How do you propose to use the Baptist Health/Wolfson Children’s Hospital name and/or logo? (select all that apply)
*
Solicitation Letters
Invitations
Flyers
Press Releases
Point of Purchase Materials
Website
Newsletter
Promo Item (T-Shirts, Sunscreen, Cups, etc.)
Other
Please upload any materials you are planning to use that will include the Baptist Health/Wolfson Children's Hospital name and/or logo for review prior to production.
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Will you provide general liability insurance for the event?
Yes
No
Is the Baptist Health Foundation listed as an Additional Insured?
Yes
No
Please upload a copy of your Certificate of Insurance.
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Have you ever coordinated or been involved in a project like this before?
Yes
No
If yes, please describe below:
*
I have read and agree to abide by the guidelines below.
Submit
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