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Sponsorship Request
Sponsorship Request
All requests sent through this form will be evaluated and a reply sent to the contact person listed. Be sure to read our list of projects and events ineligible for support.
Organization Name:
Address:
Contact Person Name:
Email:
Phone:
Purpose/Mission of your Organization:
What population does your organization serve?:
Elderly
Homeless
Children
Disease-specific population
Disabled
People in poverty
Other
Which geographical area(s) does your organization serve?:
Is your organization tax exempt?:
Yes
No
Your Tax ID Number:
What are you requesting?:
Event Sponsor
Monetary Donation
Advertising
In-kind services
Other
Give more details of your request:
For example: Event Name, date, location, dollars requested donation amount, ad specs/ad due date, etc.
List Baptist Health Deaconess employees involved with your organization and their role:
Board member, volunteer, etc.
Has Baptist Health Deaconess funded your organization or this event in the past?:
Yes
No
Attachments:
Attach a copy of the organization's W-9 form:
If tax ID not available, attach copy of tax exempt status:
Attach any other relevant files:
Community Health Programs
Community Health Needs Assessment
Sponsorship Request
Event Request
MyChart
Classes + Events
Pay My Bill
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