Good Shepherd Hospital About Us Community Outreach Sponsorship and Grant Request

Requests for support

TO REQUEST A SPONSORSHIP, PLEASE FILL OUR THE BELOW FORM

Each year HSHS Good Shepherd Hospital receives requests for sponsorships, donations and staff participation for many worthwhile causes and events in our community. However, due to the COVID-19 pandemic we are not processing any requests for support at this time. We appreciate your interest and plan to reevaluate the process in August. Thank you and stay safe!

The request is for (please check one):

Financial Sponsorship
In-Kind services (staff, supplies, printing, etc)
Other (please specify below)

Other:

Name of Organization:

Type of Organization:

Supporting Document Upload:

Number of people served by your organization/group:

Address:

Contact Name and Title:

U.S. phone number:

( ) -

What priority health need does your event/project address?:

Approximately how many individuals does your event/project benefit?:

Date of Event or Project:

Today

Location of Event or Project:

How many years has this event or project taken place?:

Expected Attendance Number:

What are the sponsorship levels and associated benefits?:

Is there any exclusivity within sponsorship levels? If so, please explain:

How will the sponsorship dollars be used?:

What percentage of your event or project's proceeds will remain local, in the Chippewa Valley?:

Is there an HSHS colleague who currently volunteers with your organization? If so, please list name.:

Is there an opportunity for our hospital to have a booth, hand out hospital-related materials, or have a hospital colleague speak at the event? If yes, please describe:

Confirmation Email:

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