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Community Vitality Funding

For questions regarding this form, please contact Julie Jank at Julie.Jank@allegiancehealth.org or (517) 205-7455.

Personal Information

Details of Request


Please indicate the type of support you are requesting:

$


Please indicate whether any of the following opportunities are provided to sponsors:



Please indicate the primary audience(s) served (check all that apply):




Please indicate your desired deadline for a confirmed sponsorship or donation.


Information in the form of flyers and sponsorship levels is appreciated. After submitting the form, please email them to Julie Jank.

Improve My Health

If you experience signs of a heart attack, chew an aspirin and call 9-1-1. Heart attacks are caused by blood clots in the heart arteries and aspirin helps reduce these clots.