Employee and Volunteer Sponsorship Form

Program Eligibility:

The request must support St. Peter’s mission, vision or values.
The request must be related to health and wellness, which include but are not limited to: social determinants of health, the Community Health Improvement Plan or the Community Health Needs Assessment.
The organization and activity must be located within our five county service area (Lewis and Clark, Broadwater, Powell, Meagher and Jefferson counties).
The organization must be a tax-exempt 501c3 nonprofit, public agency, or school.
Any St. Peter’s employee, regardless of FTE status, or volunteer can submit one request of up to $150 per fiscal year to support a local nonprofit or organization. Fiscal year runs June 1 through May 31.
You or an immediate family member must be personally involved with the organization (e.g., participant, volunteer, etc.).
This program does not match employee donations and does not serve as a donation to the organization on behalf of the employee.
We have funding allocated per quarter. Funding will be granted on a first-come, first-served basis.
- December 1 - February 29
- March 1 - May 31
- June 1 - August 31
- September 1 - November 30
Employees and volunteers can request funding to support an organization or a group. We will not grant funding to support a single employee, volunteer or family (e.g., ‘Go Fund Me’ fundraisers are not eligible).
No philanthropic gifts to sectarian, denomination, or religious organizations for support of theological functions.
Organizations are required to recognize St. Peter’s sponsorship (e.g., Facebook post, logo on poster, banner at event, etc.).
Sponsorship funding will not be available for political campaigns, candidates or parties, or partisan activities.

Completed applications will be reviewed regularly. We encourage you to apply at least one month in advance of when the funding is needed.

First and Last Name

Your SPH Email

Your Phone Number

Your SPH Department

Funding Deadline

Your requested funding date must be at least two weeks after you submit the application.

$ Amount of Funding Requested

Maximum amount $150

Organization Details

Your organization must be a 501c3 nonprofit, public agency, or school. Please answer the questions below as they relate to your organization.

Organization name

Organization point of contact name

Organization point of contact email address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Organization name that SPH will make the check payable to

What is your involvement in the organization?

For example, are you a volunteer? Is your child or partner involved in their work? Are you a member of their board?

What will the organization use the funding for?

For example, will it be used to purchase supplies? Print team posters?

How will St. Peter’s be recognized?

For example, will the St. Peter’s logo be included on a team uniform or banner? Will the organization share that St. Peter’s provided support on their Facebook page?

Does your organization’s mission and operations directly impact health and wellness?

Please attach your organization's W-9 to this submission.

If you do not attach your W-9, we are unable to receive your submission.

One file only. 100 MB limit. Allowed types: gif, jpg, png, tif, txt, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mp3, zip.

Please confirm you have attached a W-9.

After selecting submit, you will receive a confirmation email. If you do not get a confirmation email, we have not received your request and you will need to resubmit, making sure you have attached a W-9.

CAPTCHA