Sponsorship Request Form

About AOC

Please complete the form below.
* Denotes required fields

Company Information

* Name of Organization:
* Address:
* City:
* State:
* Zip Code:
* Phone Number:
Fax Number:
Website Address:

Request Information

* Please provide a description of your request and provide specific details on how success will be measured. (500 characters)

* Are other orthopaedic providers currently sponsoring this request?

* Please explain how this sponsorship benefits the community and AOC. (1000 characters)

If this event is a race, would you be interested in receiving medical coverage provided by AOC?

How many people in AOC’s service area will directly and/or indirectly benefit from this program? (500 characters)

What similar programs exist in this area? (500 characters)

Please upload all event documentation here (i.e. letter requesting sponsorship, form to be completed, etc.):
*Attachment:
Optional Attachment:
Optional Attachment:
Optional Attachment:

For any information required from AOC, please provide the following:

* Deadline:
* Dollar amount of request:
If you need our logo, what format do you prefer? (TIF, EPS, JPG)
Dimensions/sizing required (banners, signs, billboards, etc.):
If you need goody bag items, what is the requested quantity?
If you need a door prize, what is the requested dollar value?

If you have additional information, please comment. (500 characters)

Contact Information

* Contact Person:
* Are you an AOC employee?
* Is there an AOC employee on your board/organizing committee?
* Contact's Phone Number:
* Contact's Email Address: