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Please complete the application below. Due to the large number of requests, we receive, we do not accept meeting requests after our initial evaluation of the proposal. If our reviewers need additional information, you may receive a request for a follow-up teleconference.

**Important: If you have additional materials you would like to include with this application, please email them to: HGBsponsorship@humana.com

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* 1. Organization name

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* 2. Organization webpage

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* 3. Is the organization an IRS-Qualified 501(c)(3), or 501(c)(4) non-profit organization whose mission and programs are consistent with our areas of philanthropic interests? Sponsorship requests for organizations that are not an IRS-Qualified 501(c)(3), or 501(c)(4) non-profit organizations will not be considered.

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* 4. Organization's mission and vision

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* 5. Requester name

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* 6. Dollar amount requested

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* 7. Decision deadline

Date

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* 8. Event name

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* 9. Event webpage

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* 10. Description of event

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* 11. Date of event 

Date

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* 12. Point of Contact (POC) name

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* 13. POC email (ex: 123@myemail.com)

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* 14. POC phone (ex: 000-000-0000)

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* 15. Executive Director (ED) name

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* 16. ED email (ex: 123@myemail.com)

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* 17. ED phone (ex: 000-000-0000)

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* 18. Briefly describe the sponsorship request in one - two paragraphs and include the following information: How the sponsorship will provide value to Humana Military and how Humana Military's funds will be used.

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* 19. Briefly describe how your event or organization does the following for Active-Duty Service Members (ADSMs), National Guard and Reserves (NGR), Veterans, and their families and Gold Star family communities. Consider how you might improve their wellness, quality of life, rehabilitation or behavioral health. Do you honor or provide recognition for their contributions?

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* 20. Why would Humana Military be proud to be associated with your event/sponsorship?

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* 21. How many times have you organized this event?

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* 22. How many sponsors will the event have?

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* 23. What other companies will be sponsoring the event?

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* 24. Please describe your varying levels of sponsorship

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* 25. Does the requested proposal include requests for sponsorship/funding of the following: individuals or sports teams, general operating costs, travel costs (including student trips and tours) or political organizations (such requests are referred to our Government Relations Department for consideration). Or does your organization: restrict their services to members of a religious or ethnic group or discriminate on the basis of color, sex, religion, nationality, age, disability or sexual orientation?

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* 26. Has Humana Military sponsored your organization or event in the past? When and how long?

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* 27. If you have discussed this sponsorship request with a Humana Military representative or have worked with a Humana Military resource for this sponsorship in the past, please provide their name below.

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* 28. What are the demographics of your target audience?

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* 29. Please describe your community reach

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* 30. Anticipated attendance/participation at the proposed event/program

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* 31. Newsletter size

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* 32. Please list your social media accounts (Facebook, Instagram, Twitter, LinkedIn)

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* 33. I agree to send an impact report post event by end of year on participation, outcomes, testimonials and social media coverage as part of Humana Military’s sponsorship. All information received must be made publicly available through the organization’s channels prior to submittal.

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