Sponsorship Application

We proudly sponsor many different types of events and organizations. To be considered for a sponsorship, the following form must be completed. The more information that is provided, the better we can assess whether your opportunity lines up with Valley Health’s mission, vision and values.

Please note: Submitting a form does not guarantee a sponsorship as funds are limited. 


Contact Information

Valley Health Employee YesNo

First Name (required)

Last Name (required)

Email (required)

Phone (required)

Organization Information

Organization Name (required)

Address Line 1 (required)

Address Line 2

City (required)

State (required)

Zip Code (required)

Non-Profit YesNo

Organization Type
EducationHealth & WellnessReligiousSportsOther

Event Name (if applicable)

Event Date (if applicable)

How many people are expected to attend your event?

Describe your organization or event. (required)

Please explain how your organization or event helps further Valley Health's mission "to provide quality healthcare to all individuals, emphasizing outreach to those who are underserved." (required)

Additional Materials

Please attached a pdf, image or document detailing the specific request (such as product donation or monetary request) on your company letterhead (if available) as well as any fliers or other information regarding your request.

Limit of 4 files. Maximum file size should not exceed 5 MB. Supported file types include .jpg, .png, .pdf, .doc and .docx.

By submitting the information above, I understand that this does not guarantee a sponsorship as funds are limited.