Sponsorship Request | PINNACLE Orthopedics and Sports Medicine

Name*
First Last
Email*
Phone
Name of the organization*
e.g. Red Cross
Is this a 501(c) 3 organization?
- Yes
- No
Organization address*
Street Address Address Line 2 City State ZIP Code
Name / Title of Event
Date of the event/request
Date Format: MM slash DD slash YYYY
Address of the event
Street Address Address Line 2 City State ZIP Code

if applicable
Is this an annual event/request?*
- Yes
- No
How many attendees are you expecting?*
Or how many people will be made aware of Treads 'N' Threads?
Request for:*
- Medical Support
- Donations
Are you a Pinnacle Orthopedics Patient?*
- Yes
- No
Will Pinnacle Orthopedics be recognized with this sponsorship? If so, how?*
Additional comments
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