Event Request Please fill out the form to the best of your ability. If you do not know an answer to a question, simply write “not sure”. Getting to Know You Your name Your email address Your phone number Event organizer’s name Event organizer’s email address Event organizer’s phone number Are you a OneLegacy Ambassador? NoYes Will you be attending this event? YesNoNot Sure About Your Event Name of the event Event start date Event end date Event start time Event end time Event venue / location Event address Parking instructions for the event Event website (if applicable) Our cost to participate in the event If payment is requested, please attach a current W9Please note that OneLegacy operates on net 30 payment terms. Will OneLegacy need to provide a certificate of insurance? YesNoNot sure Approximately how many attendees will be at the event? Goal number of donor registrations What type of event is this? Please check all that apply. Awards Show Blood Drive Community Festival Gala General Education Golf Tournament High School Event Health Fair Hospital Presentation Hospital event – ER Hospital event – ICU Hospital event – NICU/PICU Hospital event – Social Work Hospital event – Chaplain Music Festival Parade Run/Walk Virtual Event Other Should the OneLegacy PINK DONOR DOT mascot to attend the event? YesNoNot sure If there is a informational flyer for the event, please upload here: Supporting Your Event Please check the following items needed from OneLegacy Tables Chairs EZ-Up Tent Promotional items Will a OneLegacy Representative need to attend this event? YesNoNot sure Please write a description of the event and why you are requesting OneLegacy support Upload your logo here: Sponsorships Is OneLegacy being asked to sponsor the event? YesNoNot sure If so, what is the requested amount for the sponsorship?