Contact Us

Name:*
First Last
Title:
Organization:
Email:*
Contact Number:
Mailing Address:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Has Access sponsored your organization in the past?
- Yes
- No
Event/Program Dates?
MM slash DD slash YYYY
Title of Event/Program:
Address of Event/Program:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Describe the goals of the event/program:
Event URL and/or other web links:
Target Audience:
- Deaf and Hard of Hearing
- Interpreters
- Other
Expected Attendance:
How does your organization intend to advertise the event/program?
Additional event/program information:
Sponsorship Type:
- Financial
- In-Kind
- Other
What are the benefits to sponsors for supporting your event/program?
By what date are you requesting sponsorship be provided?
MM slash DD slash YYYY
Attachments (Optional):
Max. file size: 32 MB.
By submitting this request for sponsorship, you confirm that your event or program serves and includes the Deaf and Hard of Hearing Community and in no way discriminates on the basis of gender, race, sexual orientation, national origin, religion, age, marital status, or disability.*
- I confirm
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CONTACT US