Sponsorship Request Form | United Health Services

Organization Name

Contact Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number

Email Address

Your organization is:

For-Profit

Non-Profit

Tax ID#

Tax Exempt Status

Event Name

Nature of Event

Event Date

Event Location

Target Audience

Projected Attendance

How many years has this event taken place?

What was last year's attendance?

Cash Donation - Describe Purpose

In-Kind contribution - describe items/services requested and quantity needed.

Event/program sponsorship - Please attach varying sponsorship levels with associated benefits in an email to Sponsorships@nyuhs.org

Yes, I will email attachments.

No, I do not have any attachments.

Are you requesting UHS staff/volunteer participation at the event?

Amount Requested

Are there any other sponsors already committed?

Describe how your organization and/or this event addresses a community health care need.

What are the marketing and communications opportunities for UHS associated with this event, both in advance and at the event?

Is there an opportunity for a hospital representative to have a speaking role at the event? If so, please describe.