Request for Sponsorship

Organization name *

Organization address *

Contact name *

Contact phone number *

Contact email address *

Tax ID for nonprofit organization

County / counties your organization serves (check all that apply) *

Select which objective your request meets *

Describe the primary objective of the organization, event or project *

For event sponsorships, please provide event details, including name, type of event, date, location and any other additional information. *

For event sponsorships, indicate whether alcohol or tobacco is a key part of the event *

Requested donation from Lima Memorial *

Describe the various levels of sponsorship and associated benefits for each, as applicable

Describe who will benefit from the donation *

Expected audience, including size *

Describe the publicity plan for the event *

Estimated expenses as a percent of receipts *

List other healthcare participants, if any *

List other major sponsors and contributors *

Include any additional information you wish to share

Form Submissions

Please wait for the Thank You page to confirm your form has been submitted.