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Sponsorship Request For Funding/Event Form

If you would like Cooper University Hospital to consider a request for sponsorship, donation, event participation or contribution, please complete the form below.

Event Name:
Date of Request:
Amount Requested:
Name:
Organization:
Address
City:
State:     Zip: 
Telephone:
E-mail Address:

Event Details (date, location, day of event involvement, giveaways to be provided at event, recognition of Cooper University Hospital at event, other marketing needs, etc):

Project Description: Briefly describe sponsorship, how the funds will be used, how it supports the priorities identified in Cooper sponsorship guidelines, who will benefit from donation
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