Financial Sponsorship Request Form 2019

Organization Info

Contact Person:

First Name

Last Name

Contact Phone Number:

Organization Name:

Organization Website:

Organization Tax ID #:

What area do you serve (city, state, county)?

Mailing Address:

City:

State

Zip Code:

Details of Request

Type of Sponsorship Request

Amount of Request:

Event/Project Name:

Event/Project Date(s) and time(s):

Event/Project Location with address:

Overview

Projected attendance/participation: (if not applicable, use n/a)

Who will be served by this event and how does it help empower low-income individuals and/or strengthen local communities of Wayne County:

Due date of materials/funds:

Please specify request details:

Other sponsors involved and their level of commitment:

Please identify opportunities for Wayne Metro involvement beyond sponsorship:

Please upload any supporting materials or flyers:

A. If awarded, the organization MUST complete a Sponsorship Report Form within 14 days after the event. The report form will capture highlights of the event including number of people in attendance, number of people who benefitted from the event, number of Wayne Metro staff volunteers, and number of Wayne Metro referrals who benefitted from the event. The report form can be found on the website.

If awarded, will the organization provide the completed form within 14 days after the event?

YesNo

Contact Information