St. Mary'S Health Care System Sponsorship/donation Request Form Page 2

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Project   D escription:   ( Briefly   d escribe   t he   s ponsorship   o r   c haritable   d onation,   h ow   t he   f unds  
will   b e   u sed,   o ther   s ponsors,   a nd   h ow   t he   s ponsorship   w ill   b enefit   S t.   M ary’s   H ealth   C are  
 
System   –   a ttach   a dditional   m aterials   i f   n ecessary).  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Please   i ndicate   w hich   o f   t he   S t.   M ary’s   H ealth   C are   S ystem   S ponsorship/Donation   C riteria  
 
this   r equest   a ddresses:  
 
____   Support   St.   Mary’s   Mission   to   be   a   transforming   and   healing   presence   within   our  
communities.  
 
____   A ccess   t o   H ealth   S ervices  
____   O besity    
 
____   D iabetes  
 
_____Stroke/Cardiovascular   D isease    
_____Physical   A ctivity   &   N utrition    
 
_____Reaches   t he   p oor   &   u nderserved    
______Other:    
 
Please   m ake   s ure   y our   r equest   i ncludes   a ll   o f   t he   f ollowing:    
• ____  
S t.   M ary’s   H ealth   C are   S ystem’s  
S ponsorship/Donation   R equest   F orm        
• ____   C orresponding   D ocuments   ( any   a dditional   d ocuments   y ou   w ould   l ike   t o   a ttach)  
Submit   S ponsorship/Donation   M aterials   t o   t he   a ttention   o f   M elissa   M cDaniel,   A dministrative   A ssistant  
Marketing.  
Email   t o:  
m
  o r   f ax   t o:   7 06-­‐389-­‐3891  
Mail   t o:   S t.   M ary’s   H ealth   C are   S ystem,  
 
Attn:   M elissa   M cDaniel,   M arketing   D epartment    
1230   B axter   S treet   A thens,   G A   3
0606  
 
 
For   o ffice   o nly:  
Date   r eceived:   _ __________   D ate   P resented   t o   C ontribution   C ommittee:   _ _______________  
Fund   ( Y/N):______________   T ype/Amount:   _ ______________________  

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