Sponsorship Request | The Clinic at Central Oklahoma Family Medical Center

SPONSORSHIP REQUEST

Before submitting, please click here to review our Sponsorship Policy.

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Organization Name:

Organization Website:

Contact Name:

Contact E-Mail:

Contact Phone Number:

Is your organization a registered nonprofit or community organization?

Yes

Please provide your organization's mission or purpose:

Event/Initiative Name:

Event/Initiative Date:

Event/Initiative Location:

How will this sponsorship benefit the community?

Type of sponsorship requested (select all that apply):

Monetary Contribution

In-Kind Donations (e.g. products, services)

Event Participation (e.g. booths, speaking opportunities)

Other (please specify in Additional Notes/Comments section below)

Requested Amount or Value:

Make check payable to (if applicable):

Address where check is to be mailed (if applicable):

How will our organization be recognized? (e.g. logos, materials, social media mentions):

Upload Supporting Documents (if applicable):

Upload File(s)

Additional notes or comments:

I confirm that all information provided is accurate and understand that submission of this form does not guarantee sponsorship. All information provided will be treated with the utmost confidentiality and used soley for the purpose of evaluating your sponsorship request (please type your name to acknowledge):

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