Application for PeaceHealth Sponsorship - Florence

Form Description

We ask that all groups and organizations seeking PeaceHealth's financial or in-kind sponsorship complete and submit this application. You're welcome to send supplementary materials to Marketing/Communications by mail at P.O. Box 1479, Eugene, OR, 97440, or fax at 541-687-4986. To email materials or ask questions, contact Emily Dixon at, 541-686-7110.


Fill in the information below. Use the scroll bar on the right to move down the page. When finished, click the Submit button located at the bottom of the form.

Format: (999)999-9999