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Sponsorship / Contribution Application

Organization Information

Event / Project Information

Project Description
Using 2-3 sentences, describe your project – including the benefits of the project, length of time for the project to be completed, budget, other sources of income, etc. If requesting in-kind services, please provide detailed description of services requested.

Project Mission
MSHA is committed to "Bringing Loving Care to Health Care."  We exist to identify and respond to the health care needs of individuals and communities in our region and to assist them in attaining their highest possible level of health.

Beneficiary
Identify the individuals or groups that will benefit from the requested contribution/sponsorship. Include location/county served and the anticipated number of individuals that will benefit or receive services as a result of the project.

Project Goals and Outcomes

Documentation

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx.

 

Files must be less than 2 MB.
Allowed file types: pdf doc docx.

 

Files must be less than 2 MB.
Allowed file types: txt rtf pdf doc docx ppt xls xlsx zip.