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About
Board of Directors
Strategic Plan
Resources
WV AMP
News
Events
Get Involved
Contact
Donate
Become a Member
Conferences
2026 WVRHA Conference
WV Health Jobs
Leadership Program
Sponsorship Request Form
Please enable JavaScript in your browser to complete this form.
–
Step
1
of 4
Organization Name
Primary Contact Name
*
Title/Position
Email
*
Phone
Organization Website
(If Applicable)
Next
Name of Event or Program Requesting Sponsorship
Event Date(s)
Location
(City/State or Virtual)
Brief Description of the Event or Program
(What is it? Who is it for? What is the purpose?)
Target Audience (Check all that apply or describe)
Healthcare Professionals
Community Members
Students
Policymakers
Other (Please Specify Below)
Other
Next
Type of Sponsorship Requested (Check all that apply)
Financial Support
In-Kind Support
Promotional Support
Speaker/Participation Support
Vendor Support
Other (Please Describe)
Other
Requested Sponsorship Amount
(If Applicable)
How will WVRHA’s sponsorship be recognized?
(Example: logo placement, verbal recognition, signage, website, social media, etc.)
Next
How does your event/program align with rural health or WVRHA’s mission?
What impact will this event/program have on rural communities in West Virginia?
Have you previously received support from WVRHA?
Yes
No
If yes, please briefly describe.
Additional comments or information you would like us to consider
I understand that submission of this request does not guarantee sponsorship and that all requests are reviewed based on alignment, availability, and organizational priorities.
*
Yes
event/program the to
Submit
