Host an Event for UVA Health

Thank you for your interest in hosting an event to benefit UVA Health. We’re happy to give you advice and offer tools that will help make your event a success.

Please complete and submit this form and we will contact you to discuss your event and its fundraising possibilities.

Please tell us about yourself:

If you have previously registered, please to prepopulate your information.


	Title:
*	First Name: Required
*	Last Name: Required
*	Email: Required
*	Phone Number: Required
*	Date of Birth: Required	Date of Birth:
	If you respond and have not already registered, you will receive periodic updates and communications from UVA Health Foundation.
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Question - Required - Is this a new event or a returning event benefiting UVA Health?

Question - Required - Is UVA the sole beneficiary of your event? Yes
No

Question - Required - Date of Event

Month

Day

Year

Question - Not Required - Organization Name

Question - Required - Are you a 501(c)(3)? Yes
No

Question - Required - Location of event (please provide address)

Question - Required - Please describe your event

Question - Required - What is your fundraising goal?

Question - Required - Number of people you think will attend

Question - Required - Which area of the Health System will this event support?

(Maximum response 255 chars, approx. 5 rows of text)

Question - Required - How do you plan to fundraise for this event?

	Outright donations
	Ticket sales
	Event registrations
	Auction
	Sponsorships
	Raffle

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Host an Event for UVA Health

UVA Health

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