Tenet Healthcare Central Valley Area Sponsorship Application

* indicates a required field

Please select the facility you are requesting a charitable contribution/sponsorship from:

Are you a 501(c)(3) organization?

Yes
No (by selecting this, you will be unable to continue application due to not meeting criteria)

Organization Name:

Organization Address:

Contact Name:

Contact Phone:

Contact Email:

Provide a brief description of your organization, mission and cause:

Why do you think we would be a good partner for this event?

Please list the event(s) information below:
If event is not yet finalized, please list month of event or To Be Determined (TBD).

Event Name 1

Event Name 2

Event Name 3

Event Name 4

Event Name 5

Date 1

Date 2

Date 3

Date 4

Date 5

Requested Financial Amount 1

Requested Financial Amount 2

Requested Financial Amount 3

Requested Financial Amount 4

Requested Financial Amount 5

Please list all sponsorship levels and benefits available for each event (if possible, attach your event(s) flyer):

Have we sponsored your organization’s event(s) in the past? If so, please describe and include sponsorship level:

Is anyone in your organization (board member, staff, volunteer) affiliated with our facility?

Please describe

Please attach your organization’s W-9 (Version 2018 or newer):

Please attach your organization’s W-9 (Version 2018 or newer): field is required

Additional Attachments

If your application is approved to move forward, additional paperwork will be required to fund.