Community Sponsorship/Partnership Request Form

Thank you for your interest in seeking support from Regional Health. The health and well-being of the communities we serve is important to Regional Health. We believe in growing strong partnerships and consider sponsorships an investment that supports our purpose of “Helping Patients and Communities Live Well.”

Guiding Principles
Funding priority is given to requests that support the overall objective of improving and sustaining quality of life and living. 

Regional Health considers all applications for sponsorship without discrimination based on race, color, religion, or age.

Events and programs that address one or more of the following areas will be given priority for sponsorship funding:    

  • Focus on health promotion and disease prevention that improve health and wellness of the patients and communities we serve
  • Enable long-term community capacity building and sustainability
  • Programs, events, and organizations who demonstrate partnership building and collaboration
  • Focus on special social and welfare needs such as homelessness, youth education, care for the poor and underserved
  • Requests that cover a broad range of Regional Health’s service area

Regional Health may be able to provide contributions in the form of in-kind gifts. In-kind gifts are goods or services that do not involve a monetary contribution and may include the following: meeting room space, programs, speakers, health screenings, volunteers and other services.

Strategic and financial priorities can change, which means previous approval does not guarantee future financial or in-kind assistance. Requests are reviewed within the context of available funds.

Regional Health does not provide sponsorship funding for the following:

  • Advertising
  • Events or services outside our geographic service area
  • For-profit business organizations or events
  • Individuals
  • Objectives that do not aligned with our purpose
  • Religious or political groups or events/activities
  • Regional Health physician and/or caregiver personal objectives (i.e. supporting a specific caregiver’s child’s sporting event a program that does not meet the overall community or regional focus)

Requests serving residents of Regional Health’s service area will be given priority. The Regional Health service area includes the following counties in western South Dakota and eastern Wyoming: Pennington, Lawrence, Meade, Butte, Custer, Fall River, Oglala Lakota, Crook, and Weston.

Request Process
Anyone requesting funds or sponsorship from Regional Health is asked to follow the process outlined below. Due to the large volume of inquiries, requests should be made no less than 120 days prior to the date in which the donation is needed. Also, when considering commitment dates, organization/groups should keep in mind their deadline dates for printing, advertising, etc. rather than the event date. *If requests are not received within the stated timeframe, Regional Health reserves the right not to consider the request.

  • Complete and submit sponsorship application below. All requests must be completed using this form. Auto populated/form letters will not be accepted in place of the sponsorship request application.
  • If the request includes any in-kind printing, review the Donated Printing Guidelines and note that print requests must be submitted at least six (6) weeks before items are needed.
  • Include any brochures, flyers, or information detailing the event or organization with the submission. (Please upload documents by using the link below.
  • Complete and upload the Budget Worksheet with your request (use provided template)
  • Organizations submitting for multiple events/programs throughout the year must combine all requests into one form so we have a full picture of your organization's needs. This includes in-kind donations such as printing, volunteers, and giveaway items or door prizes that will be needed.

If you have questions about any of the above, please email Michele Loobey-Gertsch, Manager Community Relations

Requesting Organization Information

Type of Request (Select all that apply)

If this is a printing request, please download and review the guidelines.

Contact Information (required for consideration)

Note: Please provide point of contact for this request

Request Information

Note: Please submit 1 request for multiple events or sponsorships. Include additional events/sponsorships in the formal letter.

Program/Event Information