Sponsorship Application

Organization Name:  *Address of Organization:  *Primary Contact Name:  *Primary Contact Phone Number:  *Primary Contact Email Address:  *Organization's Purpose/Mission:  *Is your Organization a non-profit?  *Amount Requested:  *How do you intend to use these funds?  *What type of funding are you requesting (i.e.:cash grant, matching grant, in-kind donation, etc.)?  *Do you have a contact or relationship with anyone within Parkview?  *Are you open to logo placement on T-shirts or jerseys?  *How many people participate in your organization or program annually?  *Who are the individuals/members that your organization serves?  *Is, or has, your organization received funding from any other Parkview entity or affiliate?  *Are you pursuing funding from any other healthcare organization?  *Parkview’s mission is to improve health of our community. Please briefly explain how your organization strives to promote this mission.  *Do you have a contact or relationship with anyone at Parkview?  *If yes, who? Is/has your organization receiving funding from any other Parkview entity or affiliate?  *If yes, who? Are you pursuing funding from any other healthcare organizations?  *If yes, who? 

If this sponsorship request is for an event, complete the following:

 
Date of event: Location of event: Is signage placement available at your event location? Do you publish and distribute an event program? Are sponsors able to provide public service announcements at events? How many attendees do you expect? Will you have other sponsors? 
 

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