Community Outreach Event/Sponsorship Request Form

Please use this form to submit a request for Event/Sponsorship. after submission, a DHCD employee will contact you regarding your request for event/sponsorship. For more specific information regarding Sponsorship criteria, see DHCD's Sponsorship Policy. Note: Event requests should be submitted at least 2 weeks prior to the scheduled Event. This session will time out after 60 minutes. If the form is not completed within 60 minutes of opening it you will need to start over with a new form.

Required fields marked with * sign

General Information 

Organization:	*
Street Address:
City:
State:
County:	Allegany Anne Arundel Baltimore Baltimore City Calvert Caroline Carroll Cecil Charles Dorchester Frederick Garrett Harford Howard Kent Montgomery Prince George's Queen Anne's Saint Mary's Somerset Talbot Washington Wicomico Worcester
Zip:
Organization Type:	Non-Profit Faith-Based Elected Official For-Profit State Agency Federal Agency Local Agency Veteran *
Contact Name:	*
Phone Number:	*
Cell Phone Number:
Email Address:	*
Name of the Event:
Event Location:
(Please provide the address of the event location if it is different than the organization's address)
Street Address:
City:
State:
County:	Allegany Anne Arundel Baltimore Baltimore City Calvert Caroline Carroll Cecil Charles Dorchester Frederick Garrett Harford Howard Kent Montgomery Prince George's Queen Anne's Saint Mary's Somerset Talbot Washington Wicomico Worcester
Zip:
Event Start Date:	*
Event End Date:	*
Event Start Time:	*
Event End Time:	*
Mailing (you are requesting that DHCD send brochures for your event or to your organization)
Sponsorship (you are requesting that DHCD sponsor your event)
Event (you are requesting that DHCD participate as an exhibitor, presenter or panelist at your event)

Information required for Sponsorship requests only 

EIN:
Requested Amount: $:
Are you MBE Certified?:

Staff Needed :	YesNo