Host a Fundraiser and Partner with Stony Brook Medicine to Make a Difference!

Stony Brook Hospital, Stony Brook Health Sciences Schools, and our numerous departments and programs rely on the support of our community to advance clinical care, promote wellness, and drive critical medical research. We are grateful for the individuals, companies, foundations, and organizations who contribute their time and resources to help us achieve these important goals. Such activities, when consistent with Stony Brook Medicine’s mission, objectives, and brand, a repivotal means for growing community awareness and raising much-needed resources to assist in our clinical, research and teaching mission.

Please complete the application form below.

(Note: In addition you will need to fill out the Budget Proposal Form)

Name of Event / Promotion:

Contact Person:

Address:

Address

Address 2

City/Town

ZIP/Postal Code

Daytime Phone:

Cell Phone:

Does this Event/Promotion Last More Than One Day?

Yes

Proposed Date of Event:

Start Date of Event:

End Date of Event:

Is This Event/Promotion Open to the Public or By-Invitation-Only?

Public

By-Invitation

Admission Fee/Ticket Price/Required Purchase Amount: $

Estimated Number of Attendees/Participants:

Projected Gift to Stony Brook Foundation (net proceeds after expenses): $

Please describe your event or promotion plan in detail.

Attachments of Event or Promotion Plan

Upload requirements

Publicity and Promotion
Please list the types of promotional materials (poster, flyers, mailers, etc.) and communication channels (web, email, social media, etc.) your organization plans to use to promote your event:

Publicity and Promotion Textarea

Do you plan to use the Stony Brook name to promote your event/program?

Yes

Please indicate which of the approved usages you intend to incorporate into your marketing (see our FAQ on Third Party Fundraising and Promotions for a list of approved usages).

First text reference:

Second and subsequent references:

If your event or organization has a logo, please upload it here for review:

Upload requirements

Please remember: Stony Brook University must review and approve all publicity materials which include references to our name(s).

I agree that I have read in full and agree to adhere to the Stony Brook Medicine Policies, Criteria and Guidelines for Community Partner Fundraising and Promotions, available online at https://www.stonybrookmedicine.edu/community-fundraising/guidelines.

Name:

Name of Organization:

Date of Application:

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