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UnityPoint Health – Quad Cities Community Sponsorship Application
Organization Name
Tax ID
Contact First Name
Last Name
Address
City
State
Zip
Phone Number
E-Mail
Organization Website
Is your organization a 501(c)3?
Yes
No
What percentage of your dollars stay local?
Please state your organization's mission:
How do your organization's programs/events align with UnityPoint Health's priority funding areas?
Does your organization have any UnityPoint Health employees on its Board of Directors?
Yes
No
If yes, who?
Who is your organization's target audience?
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