Sponsorship Request

United Regional’s passion is to provide excellence in health care for the communities we serve. As such, we endeavor to support the efforts of organizations that support the health and well-being of our community.

As a non-profit healthcare organization, United Regional gives careful consideration to requests for financial and in-kind support. We will consider both external and internal requests for sponsorships of relevant projects and events, along with support of nonprofits and/or fundraising events.

Click below to review the application Sponsorship Request FAQs

Sponsorship FAQ

Community Event/Project Sponsorship Request Form

Form to complete to request sponsorship by United Regional

Today's Date:(Required)

Contact Name:(Required)

First Last

Phone:(Required)

Mobile:(Required)

Email:(Required)

Organization:(Required)

Purpose/Mission of your Organization:(Required)

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Tax-exempt status:(Required)

IRS 501(c)3

Gov’t agency/school Choice

Other

Amount Requested (Be Specific):(Required)

Date contribution is needed:(Required)

Event/Project Name:(Required)

Event/Project Date(s):(Required)

(ex mm/dd/yy – mm/dd/yy)

Who will be served by this event/project(Required)

(demographics, number of people served)?

How will this event/project improve the healthcare status of our region?(Required)

How will you measure your results?(Required)

Does the sponsorship include a program advertisement?(Required)

Yes

If approved, how will United Regional be recognized for this sponsorship?(Required)

Other anticipated funding sources for the event/project:(Required)

Attach any supporting documentation needed (i.e. sponsorship levels, event details)

Max. file size: 256 MB.

Signature(Required)

First Last