Event Sponsorship Request Form | Goodman cancer Institute

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Event Sponsorship Request Form

Reagent Request Formbouton
GCI

Request for Event Sponsorship 

General Information Name of organization
									
 Department
									
 Name of requestor
									
 Phone number
									
 Email
									
Billing Address Billing address - Street
									
 Billing address - City
									
 Billing address - Province
                                
 Billing address - Postal code
									
 Billing address - Country
                                
Event Information Name of the event
									
 Contact person
									
 Email
									
 Phone number
									
 Address
									
 Name of the venue event will be held
									
 Venue address
									
 Web address for the event (if available)
									
 Proposed date of the event
 How may attendees do you expect at your event?
									
 How many staff and/or trainees of the GCI will likely attend?
									
 What is the target audience of your event? (Check all that apply)
								
								Basic biomedical researchers
							
								Clinical researchers
							
								Trainees
							
								Patients
							
								General public
							
Sponsorship Information Amount requested from GCI
									
 Total budget of your event
									
 Has the GCI sponsored your event in the past?
						
							Yes

							No
 If yes, please lists dates and GCI sponsorship amount in the box below.
									
 Briefly describe how GCI funds will be used in support of the event.
									
 How will the GCI be acknowledged as a sponsor of the event?
									
 In the box below provide a brief description of your event, its expected goals  and how it advances the cancer research mission of the GCI. (2000 char max)
									
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Request for Event Sponsorship
