Community Grant Program

Please review our Donation Guidelines before submitting your request.

Name of Organization:

Street Address

Address Line 2

City

State

ZIP Code

Contact Person:

Phone:

Email:

Preferred Method of Contact:PhoneEmail

Organization Web Address:

What area does your organization serve?

How does your organization serve our community?

Please describe your request:

How does this donation or item benefit the community if approved?

Has Shoals Hospital donated to your organization in the past?YesNo

Type of Request:MonetaryItem

How will Shoals Hospital be acknowledged for the donation?

Do you need a logo or advertisement?YesNo

I've read and understand the Donation Guidelines:Yes