HSHS Sponsorships
organization
Organization Address
Organization City and Zip Code
Contact Name
Contact Phone Number
Contact E-Mail
Beneficiary
Beneficiaries Tax-Exempt 501(c)3 ID
List the primary county the Benefiary supports
Event Name
Event Date(s)
mm/dd/yyyy
Event Location
Request
Request amount
Date approval deadline for marketing purposes
mm/dd/yyyy
Notes
Are other health care org. supporting this cause?
Has HSHS supported this event in the past?
HSHS Raffle Basket Request
HSHS In-Kind Printing Request
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