Community Outreach Application

Event/Organization Name *
Address *

Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Contact Name *
Contact Email Address *
Contact Phone Number *
City *
State *
Zip Code *
Date of Event *
Purpose of Event *
Time of Event *
Is this request for a Cash or Product Donation? *Please select if you are requesting a cash or a product donation
The minimum amount requested *
Please attach benefits / recognition for sponsorship
How Many Do You Expect Will Attend? *
Is Your Organization a 501(c)(3)Charity? *
Which IMS focus area describes your organization? *
Please list any additional information to help us in reviewing your request.
If you have another document that will help us, feel free to attach it here
Would you like to receive promotional emails from IMS? *