UnityPoint - Quad Cities | Sponsorship Request Form

Express Care - Bettendorf

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Express Care - John Deere Road

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Express Care - Moline

02 Patients
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Express Care - North Port

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UnityPoint Clinic Express Care - Rock Island

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Sponsorship Request | UnityPoint Health Quad Cities

Request for Sponsored Funds or Specialty Items

Request for Community Funding Form

If you have an upcoming event or activity that you're interested in Trinity sponsoring, please fill out the form below with as much detail as you can. We will do our best to honor as many funding requests as possible that are consistent with our mission. Generally, an organization should only submit one sponsorship request per calender year. If you haven't already done so, please review our guidelines and restrictions for funding.


* All Fields are RequiredName of Organization: Type of Organization:  Mission of Organization:Contact Person: Address:  City:State: Zip: Day Phone:  Email Address:Project/Event Description (include date, time, location, admission cost, population served, number of people served, geographic location of people served): Dollar amount requested (and/or in-kind services requested): How will the funds be used? How will this benefit community health? The history of the event: Has Trinity sponsored your organization in the past? If so, what year(s)? Sponsorship benefits that Trinity will receive:




















 Additional Sponsorship Info (sponsorship packages available, degree of sponsorship exclusivity or additional information to clarify benefits above):Please limit documents to what we have requested here. If we need additional information, we will contact you. Thank you.