Contact Us: 815-673-2311
The colors of St. Mary's Hospital, Streator, Illinois
  • About Us-St
  • Request For Support

    Every year St. Mary’s Hospital receives several requests for donations, sponsorships, and volunteering opportunities throughout it’s community. In order to create a more efficient evaluation process, we ask our candidates to complete the online form below. Although we are eager to receive these requests, we ask the form be submitted at least one month in advance. We thank you for your interest; a member of the hospital staff will contact you if your request is accepted.

    All fields are required. Only completed request forms will be considered. 
     
    Applicant Details 

     
     * Name of Organization:
     

     
     * Contact Person:
     

     
     Contact Number:
     

     
    * Address:
     

     
    * City:
     

     
    * State:
      

     
    * Zip Code:
     

     
    Email Address:
     

     
    What is the primary mission of your organization?
     

     
    Which cities or counties are served by your organization?
     

     
    Is the organization a 501C3 non-profit agency?

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    Request Details 
    Date Needed: 
     [None] Select a Date Delete the Date 

     
    Time Needed:

     
     Type of donation requested?
             
     Is there a fee involved?
             
    If so, what is the fee?

     
     Brief description of the request including how many people are estimated to be served and how the donation will be used?

     
    Will St. Mary’s Hospital receive any publicity or recognition for the donation?
             
     If so, in what form?

     
     Has St. Mary’s Hospital provided support in the past?
             
    If so, in what way?