Organization name
*
Today's date
*
Event date
*
Summary of initiative
*
Please use 1000 characters or less
1000
Visibility for WellSpan Health
*
Advertising
Event Presence
Event Tickets
Social Media
Speaking Opportunity
Website
All of the above
Other
Estimated number of attendees
*
Requested dollar amount
*
Link to more event information
Has your organization received sponsorship in the past ?
*
Yes
No
Name of campaign/event
*
Location of event
*
Region
*
East
West
Central
All
Contact Name
*
Contact Phone
*
Contact Email
*
WellSpan Contact Name
Additional Sponsorship Information
Captcha
*