Click to Call

Stamp Out Smoking News

Stamp Out Smoking Sponsorship Application

Please review the sponsorship policy of the Arkansas Department of Health Tobacco Prevention and Cessation Program prior to completing an application. If your request meets the individual funding award amount, please complete the fields below.

Applicant/Organization (required)

Contact Name (required)

Contact Email (required)

Contact Phone Number (required)

Event Requesting Sponsorship (required)

Event Date (required)

Event Location (required)

Is Your Event Smoke Free?

yes no 

What is the expected attendance of your event? (required)

What is the expected demographic of those attending your event (i.e., age, gender, ethnicity, etc.)? (required)

Please describe the purpose and details of your event: (required)

How will the event be promoted? (required)

How much are you requesting for sponsorship? (required)

What deliverables will you offer if sponsorship is granted (i.e., signage, advertising, booth space, etc.)? (required)

What is the relationship of your organization to the Tobacco Prevention and Cessation Program, if any? (required)

Share