Funding Support Request

Funding Support Request

Marinus is no longer accepting Educational Grants, Medical/Scientific Sponsorships and Corporate Membership requests at this time.

Request Type*

Commercial Sponsorship

Requesting Organization*

Program Type (choose all applicable)*

Select

Program Location (City, State; online)*

This is a recurring event

How many programs will there be?

Estimated number of participants*

Accreditation*

Select or enter value

Are there additional supporters of this program?*

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Request Submitted By*

Please enter your name as submitter

Point of Contact (Name)*

Point of Contact Email*

Check here if you are a Marinus Commercial employee

Has the ABD approved this event?

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Please list the Marinus Commercial attendees for this event

By submitting this Request for Financial Support, the applicant understands and commits to the following criteria:

Request for funding is to be solely used to support education and the requestor will not use any portion of the amount awarded towards promotion, whether for a product or a business*

Should an award be approved and granted by Marinus, the Medical Education Provider [“Provider”] will:

a. sign a Letter of Agreement (LOA) documenting the provisions related to Marinus’ granting financial support*

b. independently and objectively control the content of the Program, select the faculty, moderators, venue and target audience*

c. disclose to the audience at the time of the Program the source of funding and any relationship between the Program faculty, organizers, or moderators and Marinus*

d. bar any promotional activity (including product-related ads or displays) from the immediate area where the Program is conducted (e.g. the Program room and any adjacent hallwaysimmediately outside the program room)*

e. conduct a reconciliation of funds after the Program and provide a report to Marinus outlining the categories of spend incurred and how funds granted by Marinus were allocated to individual categories, including whether any funds were not used*

f. provide a post-event summary which includes the number of actual participants and a summary of any participant evaluations collected*

g. agree to refund any unused funds to Marinus*

Grant Request Documents

REQUIRED DOCUMENTS TO BE INCLUDED WITH SUBMISSION:

Letter of request
Program agenda (plus any description or brochure available)
Detailed budget
If an accredited program, proof of accreditation (certificate)

Sponsorship or Corporate Membership Documents

Please attach a letter of request, agenda, prospectus, invitation, or other documents as applicable to the type of request. A description of the membership or sponsorship levels available is required.

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