Event(s)/Program(s) included in Sponsorship: *

Date of Event(s)/Program(s): *

Community Impact: *

UPMC Impact: *

Event(s)/Program(s) Focus Area: (Please check one or more of the following) *

Have you received a sponsorship in the past from UPMC? *

Is your organization a Non-Profit organization?*

Are you requesting support for a religious purpose? *

Does your organization have a non-discrimination policy that ensures it does not discriminate based on race, ethnicity, color, sex, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, or marital, familial, or disability status or status as a protected Veteran or any other legally protected group status? *