Sponsorship Request Form

Sponsorship Request Form
Haitian Heritage Month
Please complete and submit this online application no later than April 1, 2026. Any application received after this date will not be eligible for consideration.

Please note that, if approved, payment processing may require up to eight weeks. Additionally, the use of any logo or likeness of the Little Haiti Revitalization Trust or the Chairwoman on event materials requires prior written approval.
Date of Request:

MonthDayYear
Date
Download - Haitian_Heritage_Month_Expenses 2026 Form
Organization Name:*
Organization Address:
Name*
Phone number:*
Email:*
Title of Event/Program:
Date of Event/Program:

MonthDayYear
Date
Time of Event/Program:

Hour Minutes

AM/PM Option
Event/Program Location:*
Expected Number of Attendees:
Age range of expected attendees:
Have you secured the date of the event with the venue:
Funding Request Amount:*
*Please note that if approved, funding payment will be remitted after the event date. Approved requests are eligible for up to $7500.00. The exact amount of funding all will be at the sole discretion of the Trust administration and the City's review committee.
Participating Event Sponsors:
Other planned or committed funding sources and the expected amount (what other sources are providing you funding):
Purpose of event/program:

How many times have you held this event or a similar event in the past and in what years?
If you have held the event in the past, what was the previous budget for this event?
Is the event/program open to the public?
Is the event/program free of charge?
If there is a charge, how much will you charge?
Will you conduct any fundraising at the event (raffle, silent auction, etc.):
Will alcohol be available at this event (either free of charge or for sale):
To have this request reviewed, please send the following information/documents along with this form.
1. COMPLETE Budget for the event (including all revenue and expenses) and the prior year's budget if the event was previously held
2. Proof of non-profit status (501c3 or tax-exempt document)
3. Copy of the proof of the organization's currently active status from the Florida Secretary of State (Sunbiz.org)
4. W-9 Tax Form
5. Mission Statement of the Organization
6. Any event marketing pieces (flyer, link to a website, etc.)
7. Copy of venue agreement
8. Information on prior similar events (number of participants, location, etc.)
9. Voided check of the organization
DOWNLOAD

Haitian_Heritage_Month_Expenses 2026
Event Budget (Complete)*

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Non‑Profit Status Proof (501c3)*

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Active Status – Florida Sunbiz*

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W‑9 Form*

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Organization Mission Statement

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Event Marketing Materials

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Venue Agreement

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Past Event Information

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Voided Check

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Failure to submit items 1, 2, 3 or 4 above will result in a delay of consideration until said items are received.
Certificate of Acknowledgment by an authorized individual representing the Organization:
I,
Name *
As
Organization Title*
Title
of the above-listed organization, am authorized to submit this funding request. I understand that falsifying anyinformation on this form or documentation provided shall result in the organization being ineligiblefor funding.
Signature*

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Note: Sponsorship funds will be provided on a reimbursement basis, after all verifiable expenditure documents are received by the Trust. Eligible receipts must be issued by a third-party vendor that provided services and must not be affiliated with the applicant. Valid documentation includes canceled checks, bank statements, and receipts with vendor name, logo and contact information. There will be no reimbursements for cash payments.
I Agree
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Sponsorship Request Form

Haitian Heritage Month