AHCG Sponsorship Application

How does this request contribute to improving community health?

Promoting WellnessEmpowering people to take part in their healthOther

Is your organization a non-profit?

YesNo

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Authorized Contact

First NameLast Name

Contact Phone Number

Please enter a valid phone number.

Describe Your Organization, Project or Event

Please describe the organization, project or event for which you are seeking a donation. For events, please include date, location and anticipated attendance.

Amount of Donation Sought

Type of Donation (Are you seeking a general donation or requesting that Adventist Health Columbia Gorge serve as financial sponsor for an event?)

General DonationFinancial Sponsorship

Please verify that you are human*

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