Appalachian Regional Healthcare | Sponsorship Request Application

Sponsorship Request Application

Our Mission

The mission of Appalachian Regional Healthcare is to improve health and promote the well-being of all people in Central Appalachia in partnership with our communities. We are committed to supporting positive community initiatives, organizations, and programs that improve the lives of all citizens we serve.

We receive many requests for financial sponsorships. While supportive of all approaches that encourage positive community improvements, we are limited in providing financial support, and must prioritize applications and projects as they are submitted.

How to Apply for Sponsorship

If you would like to request sponsorship from our hospitals, please complete the online application below, and attach any additional requested information listed in the application.

We Support

Health and wellness initiatives
Programs serving the poor and disenfranchised
Educational programs
Community based nonprofits

We Do Not Fund or Sponsor

Requests from individuals or for-profits
Programs or organizations that are inconsistent with our core values
Out of area organizations
Political action committees or political campaigns

How to Apply for Sponsorship

All applications for sponsorships must be submitted online two months prior to the date funding is needed. Emergent needs for sponsorships can be submitted in less time.
Every applicant will receive an email notification of completed submission.
ARH will review each application and applicants may be asked for additional information.
Applicants receive email notification of the outcome of the request.
Successful applications will receive a check via US Mail 3-4 weeks after approval.

Sponsorship Application Form

All requests must be made by completing this form and attaching your flyer, brochure, or request letter on letterhead. Requests must be made at least two months prior to the date needed. Please note that while all sponsorships are considered and all are worthy, those which align with our mission to help provide access to care or which promotes health and wellbeing in the communities we serve will be given greater consideration.

Today’s Date

Application Contact

Name of Organization/Group Requesting Sponsorship

Address (where check should be mailed)

City

Select State

ZIP Code

Taxpayer ID number:

(Please include your W-9 form)

Contact Person

Contact Person Telephone

Contact Person E-mail

1) Donation / Sponsorship Requested:

2) Purpose of request (what will a donation help you accomplish?). Attach additional pages if necessary:

3) Tell us about your organization, group or event. How long has it been in action:

4) Number of people attending the event and/or event reach:

5) If applicable, artwork specs (color, size, and file format):

6) If applicable, number of people viewing advertisement (impressions):

7) Does this sponsorship include advertisements that will be visible for more than one week (example: banners, scoreboards, etc. lasting an entire season)?

Yes No

8) Has your organization received sponsorship from any Appalachian Regional Healthcare entity in the past?

Yes No

9) If Yes To #8, When, For What and For How Much?

10) Are there any other healthcare related sponsors?

Yes No

If Yes To #10, Please List Other Healthcare Sponsors:

11) Is sole (exclusive) sponsorship from ARH an option for your event?

Yes No N/A

If Yes To #11, What Is The Cost?

12) Check payable to:

13) Mailing address for check:

14) Date the Check is needed

15) Please Feel Free To Provide Any Further Information Below:

Attach Additional Flyers, Brochures and/or Letterheads (Optional | PDF, JPG, PNG Up To 5MB)

NOTE: If your sponsorship includes advertisement opportunities, artwork, or logo placements, ARH must have final approval before printing or purchase.

Please attach your flyer, brochure, or letter advertising your event.

Our Mission

We receive many requests for financial sponsorships. While supportive of all approaches that encourage positive community improvements, we are limited in providing financial support, and must prioritize applications and projects as they are submitted.

How to Apply for Sponsorship

If you would like to request sponsorship from our hospitals, please complete the online application below, and attach any additional requested information listed in the application.

We Support

We Do Not Fund or Sponsor

How to Apply for Sponsorship

All applications for sponsorships must be submitted online two months prior to the date funding is needed. Emergent needs for sponsorships can be submitted in less time.

Every applicant will receive an email notification of completed submission.

ARH will review each application and applicants may be asked for additional information.

Applicants receive email notification of the outcome of the request.

Successful applications will receive a check via US Mail 3-4 weeks after approval.

Sponsorship Application Form

NOTE: If your sponsorship includes advertisement opportunities, artwork, or logo placements, ARH must have final approval before printing or purchase.

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