Community Sponsorship Request

If you wish to submit a community sponsorship request, please complete and submit the on-line request form below. If you have any questions about the form or process, please send us an e-mail communitysponsorships@atlanticare.org

COMMUNITY SPONSORSHIP REQUEST FORM

Upon receipt of this completed form, your request will be reviewed. Only requests from 501(c)(3) organizations whose mission aligns with AtlantiCare’s vision and mission will be considered.

NOTE: Items with an asterisk (*) must be completed prior to submitting!

Full Name (*)
Please type your full name.
Phone: 
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E-mail (*)
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Your Organization

Organization Name (*)
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Address:  (*)
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Address 2: 
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City:   (*)
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State: 
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Zip Code (*)
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Mission & Vision of Your Organization (*)
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Number of AtlantiCare Employees Served by Organization Annually (*)
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Number of Persons Served by Your Organization Annually (*)
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Is Your Organization Funded by the United Way? (*)
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About Your Request

Description of Community Sponsorship Request (please include information about event including event honoree) (*)
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What area of concentration does your organization fall under? (*)
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Type of Request (*)
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Name, Date and Location of Event (*)
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Ad Specs
(Format submitted by AtlantiCare will be high resolution pdf.
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Attach Document
(Must be less then 5mb and Word, Excel or PDF file)
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If approved, where should sponsorship check be sent? (*)
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To help us avoid computerized spam, please type in:  (*) To help us avoid computerized spam, please type in: 
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