Sponsorship Request Form
Please fill out the form below to request a sponsorship from one of our cancer centers. We request that you upload the sponsorship packet and any information that needs to be filled out at the bottom of this form.
Which center are you requesting a sponsorship from?
Northeastern Oklahoma Cancer Institute - Claremore, Oklahoma
Peninsula Radiation Oncology Center - Soldotna, AK
Southeast Radiation Oncology Center - Juneau, AK
Eastern Oregon Cancer Center at Pendleton, Oregon
Requesting Organization Name
Sponsorship Level Requesting
Sponsorship Amount Requesting
Does your organization serve the cancer center's local community?
Date Needed By
Name and address for where to send the check.
Any other information?
Upload sponsorship request form & W9 if we have not previously donated to you.
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