2014
Kaiser Permanente
GSAA Sponsorship
Program Guide
Thank you for your interest in the 2014 Kaiser Permanente
Southern Alameda County Sponsorship Program. Each year
through our programs, we support local organizations that are
working to improve the health of the communities we serve.
Introduction
For nearly 70 years, Kaiser Permanente's social mission has been the foundation of
its community service programs. As a values-driven, not-for-profit integrated health
care organization, Kaiser Permanente is dedicated to improving the health of our
members and the communities we serve.
This is accomplished through a variety of engagements and partnerships where we
bring a wide range of resources to support community based organizations
including: financial grants to support community activities, the provision of
volunteers, and in-kind support such as health education materials, promotional
items or speakers.
Kaiser Permanente Greater Southern Alameda Area (GSAA) Public Affairs
coordinates funding and resources to support community partners, organizations
and agencies across Southern Alameda County, which encompasses Hayward,
Fremont, Newark, Union City, San Leandro, and the unincorporated areas of
Ashland, Cherryland, Castro Valley and San Lorenzo.
Public Affairs Sponsorships
The Kaiser Permanente GSAA Public Affairs department will consider sponsorship
requests for local community activities and civic events, under the Community
Relations or Community Benefit programs.
Types of requests that will be accepted for consideration include but are not limited
to:
 Special events e.g. health fairs, dinners, lunches, cultural events or
fundraisers
 Conferences and forums
 Symposia
 Health education forums
 Health campaigns, programs and initiatives
NOTE: If your sponsorship request is strictly marketing related but benefits the
community; please contact Ana Apodaca, Community & Government Relations
Manager, at Ana.Apodaca@kp.org.
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Sponsorship requests must be in alignment with one of the identified
Community Benefit priority areas which include:
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Improve Access to Mental Health Services
Increase Access to Affordable, Healthy Food
Ensure Safe Environments Where We Live, Work and Play
Requests must be submitted a minimum of 60 days prior to the event date.
Requests received less than 60 days from the date of your event may be
immediately declined.
NOTE: After the request has been submitted, if there are any changes to the date,
time, or location of the event, we must be immediately notified of new details via
email to: GSAA-Community-Involvement@kp.org.
*If program ads, logos, and/or in-kind support are requested (e.g. tabling/staffing
support, health education materials, promotional items or speakers) please include
specifics in the application.
Eligibility Guidelines
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Kaiser Permanente will consider requests from qualified organizations
that serve our Southern Alameda Area only (Southern Alameda County)
Sponsorship awards typically range from $500 - $10,000
Only nonprofit or public benefit organizations are eligible to receive
funding. Unincorporated groups or agencies can make arrangements to
utilize an eligible nonprofit organization as a fiscal sponsor
Events/projects must address needs in the Southern Alameda Area
Strategies must be consistent with the values and mission of Kaiser
Permanente
A summary evaluation report of the event/activity, listing the number of
people who attended or were served, is required 30 days post event
date.
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Accessing the Online Application Request Tool
Sponsorship Application Website:
https://www.GrantRequest.com/SID_946?SA=SNA&FID=35245
Create a login to access the Online Application – one contact per organization,
please. This can be the same login if you have already submitted an online grant
application.
If saving and returning to the Application at a later date, use the following
URL to return to your Online Application:
https://www.GrantRequest.com/SID_946?SA=AM
Processing Guidelines
All applicants will receive notification that their application has been received within
1 – 2 weeks. Your request may take 6 – 12 weeks to complete processing. Please
submit your requests early with the required documents.
Funding Limitations
Kaiser Permanente’s Southern Alameda Area Public Affairs Department will not
consider funding requests from the following types of organizations or for the
following activities/purposes:
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Political campaigns*
Religious purposes**
Individuals and/or personal requests such as scholarships, individual
tuition, payment for educational purposes, conferences, etc.
Fraternal, athletic, international, or social organizations
Contributions to endowments or memorials
Field trips
Youth sports leagues
Tours or golf tournaments
Crab/spaghetti feeds or ice cream socials
*As a nonprofit organization, Kaiser Permanente is legally prohibited from funding
political campaigns.
** Kaiser Permanente may fund faith organizations providing secular programs that
serve the greater community. These organizations must apply under a fiscal
sponsor. A community nonprofit partner with an eligible 501(c)3 IRS status can
apply for funding as a fiscal sponsor on behalf of an inter-faith collaborative.
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Additionally, Kaiser Permanente is not able to support any organization that
discriminates on the basis of sex, age, economic status, educational background,
race, color, ancestry, national origin, sexual orientation, gender identity, and
marital status in their programs, services, policies, hiring practices, and
administration.
Tips for Successful Online Submission
We have provided the following information and suggestions to help ensure a
smooth application process:
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We will only accept applications submitted through this online form;
information entered can be saved and completed later
Save the account URL you were emailed when you created your
account. For your convenience, it is:
https://www.GrantRequest.com/SID_946?SA=AM
Use this to access any Kaiser Permanente Community Benefit /
Community Relations applications you started and/or submitted through
this online application process
Save your progress often as you complete the application
Select the Printer Friendly Version link at the top of the online
application page to preview all the questions asked
Items with a red asterisk (*) must be completed
Prior to submitting your application, you will be asked to review the
form and document attachments for completeness. Once you submit
your application, it cannot be edited
Lastly, if you forget your account password, please follow the on-screen
instructions from the account login page to retrieve your password
Required Documents
The following documents are required for submission and must be uploaded as part
of the submission. The application cannot be submitted through the online
system without attaching these documents.
1. Request on organization's letterhead (must include; the legal name of
organization, address, current date, requested amount, event title, date,
time, venue name and address and how the funds will be used)
2. Tax exempt status letter*
3. Current list of Board of Directors (must include their affiliations)
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4. Detailed event sponsorship proposal (must include; levels, benefits, i.e. # of
tickets, ads, recognition, etc., and agreement)
5. IRS Form W9
6. Itemized project budget and list of all other revenue sources along with IRS
Form 990 and an Audited Financial Statement (only required for requests over
$20,000)
*For tax exempt status verification, one of the following documents must be
submitted:
For nonprofit organizations, one of the two supporting documents must be
submitted:
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Copy of current IRS determination letter indicating appropriate taxexempt status with Tax ID number (preferable), or
Copy of the certification from the Office of the State Attorney General
where the qualified organization is registered
For government/public entities, one of the two supporting documents
must be submitted:
 Notarized letter from the organization's Chief Financial Officer or
Certified Public Accounting Firm indicating the government/public
agency has been granted tax exemption, or
 Affirmation letter from the IRS with the Federal Identification Number
Fiscal agent
If a fiscal agent is being used, then the request and required information must also
be submitted on the fiscal agency's letterhead along with the copy of the
Memorandum of Agreement. In addition, all required documentation must be
submitted for the fiscal agent organization.
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Uploading Instructions
When attaching the files, all files must be labeled as follows "Organization
Name_Document Title". For example: Valley Clinic_Board of Directors. When ready
to attach, please do the following:
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From the pulldown list, select the document ready to be attached;
Click 'Browse' button and select the file;
The file you selected will then be displayed;
Click the 'Upload' button and your file will be attached. Do this for each
required document.
The maximum size for all attachments combined is 100 MB. Please note that files
with certain extensions (such as "exe", "com", "vbs", or "bat") cannot be uploaded.
Please note that these instructions are specific to Internet Explorer. Depending on
the browser you are using, you may see slight differences in upload tools.
Contacting Us
If you have any questions about what is asked on this application form or
experience any technical difficulty, please contact Rikki Kiefer at
gsaa-community-involvement@kp.org or 510-618-5844.
Thank you for your interest in the Kaiser Permanente Southern Alameda
Area sponsorships.
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GSAA S p o n s o r s h i p G u i d e