Caring for our Community

At WHS, we are dedicated to our mission of Great Patient Care. We strive to support the healthcare needs of all local residents, even before they set foot in one of our buildings. That includes keeping you healthy and out of the hospital.

In doing so, we proudly partner with organizations and events throughout the community and carefully consider sponsorships that connect to our mission, vision, values, and pillar goals.

WHS receives hundreds of requests from community organizations and cannot fulfill every request. Although your sponsorship request may align with our mission, vision, values and strategic plan, funding may not be available due to allotted limited budget.

Before filling out this form, please note that we do not accept donation requests from:

  • School or private athletic teams, athletic fundraisers, school fundraisers, etc.
  • Religious or political causes or candidates
  • Individuals seeking financial support for their participation in a fundraising effort (example: requests for us to sponsor individuals in a race, walk or other event)
  • Programs outside of our service area

Community Support Request Form

Due to the large number of requests, we ask that you fill in the form below at least 8 weeks prior to your donation due date. Completion of this form does not guarantee acceptance. Eligible requests will be reviewed monthly by a committee to determine if they will be accepted and if funding is available.

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Organization Info

Organization Name
Field is required!
Type of Organization
  • - Select an Option -
  • For Profit
  • Non-Profit
  • Other
Field is required!
Address
Field is required!
City
Field is required!
State
  • - Select One -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
Field is required!
Zip Code
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Website
Field is required!
Social Media (if applicable)
Facebook, Twitter, Instagram, etc. Use the +Plus to add more.
Field is required!
Short description about the organization
Field is required!

Organization Point-of-Contact Info

Name
Field is required!
Company/Title
Field is required!
Connection to Organization
Field is required!
Phone
Field is required!
Email
Field is required!
Re-Enter Email
Field is required!

Donation Request Info

Has your organization requested a donation or sponsorship within the last 12 months?
Field is required!
Please Explain
Field is required!
Have we supported your organization in the past?
Field is required!
Please Explain
Field is required!
What type of donation are you currently requesting?
Field is required!
Short explanation to support the request marked.
Field is required!
Is this request for an event?
Field is required!
Name of Event
Field is required!
Date of Event
Field is required!
Time of Event
Field is required!
Purpose of the Event
Field is required!
Number of attendees
Field is required!
Tell us about your audience (who attends)
Field is required!
Upload supportive details, sponsorship packages, etc.
Supported file types: doc, docx, jpeg, pdf. Max upload size: 6mb
Upload your documents...
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Additional details you would like to share with us.
Field is required!

Completion of this form does not guarantee acceptance. Sponsorship requests are reviewed on the first Friday of every month. If you have additional questions please email: washingtonhealthsystem@whs.org