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Request for Sponsored Funds or Specialty Items

If you have an upcoming event or activity that you’re interested in Trinity sponsoring, please fill out the form below with as much detail as you can. We will do our best to honor as many funding requests as possible that are consistent with our mission. Generally, an organization should only submit one sponsorship request per calender year. If you haven’t already done so, please review our guidelines and restrictions for funding.

Request for Community Funding Form

 

Warning: any information entered on this form is not encrypted and we cannot guarantee its security in transmission.  Please do not include any sensitive health information in this form.  If you prefer, you can contact us at (309) 779-5000.

* Name of organization:
* Type of organization:
* Contact person:
* Address:
* City:
* State:
* Zip:
* Day Phone:
(-
* Fax Number:
(-
* E-mail Address:
* Mission of organization:
* Project name:
* Date:
Now
* Time:
* Location:
* Description of project (include admission cost, number of attendees, how the requested money will be used, how funds will benefit community health, history of event):
* Type of request
(check all that apply):
* Please explain:
* Please describe the sponsorship benefits Trinity will receive for its support:
* Security Code:
 Security code




 
ERWait Time Bettendorf
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10 minutes ?
as of 11:04 PM on 5/19/2013
Wait Time Bettendorf
Express Care
0 minutes ?
as of 3:32 PM on 5/19/2013
Wait Time East Moline
Express Care
0 minutes ?
as of 3:14 PM on 5/19/2013
Wait Time Moline
Express Care
35 minutes ?
as of 3:59 PM on 5/19/2013
Wait Time Muscatine
Express Care
20 minutes ?
as of 2:02 PM on 5/18/2013
Trinity Moline

Trinity Moline

500 John Deere Road
Moline, IL
(309) 779-5000
Maps & Directions
Virtual Tours
Trinity Rock Island

Trinity Rock Island

2701 17th St.
Rock Island, Il 61201
(309) 779-5000
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Trinity Bettendorf

Trinity Bettendorf

4500 Utica Ridge Rd.
Bettendorf, IA
(563) 742-5000
Maps & Directions
Virtual Tours
Trinity Muscatine

Trinity Muscatine

1518 Mulberry Avenue
Muscatine, IA 52761
(563) 264-9100
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Illinois: (309) 779-5000   |  Iowa: (563) 742-5000  |  Muscatine: (563) 264-9100  |  Health Information & Physician Referral: (877) 242-8899 | Crisis Center Hotline: (309) 779-2999