Charitable Donation Request Form

General Criteria:

Organizations requesting a charitable donation must have not-for-profit status, be in close proximity to Beacon's health care facilities, serve the individuals in our geographic regions, and support Beacon's mission to enhance the physical, mental, emotional and spiritual well-being of the communities we serve.

Beacon Health System generally does not donate to:

Individuals, Athletic Teams, Building Projects, Capital Projects, Salaries, Political Organizations, Meetings, Videos, Websites, Promotions, Festivals, Raffles, Concerts, or Deficit Funding

How to Apply:

1. To apply for a charitable donation from Beacon Health System, please complete the below request form. Incomplete applications will not be considered.

2. Applications are received and reviewed throughout the year. There is no specific application timeline. However, your application should be submitted well in advance of your project/program start date and allow time for our committee to review. Please allow up to eight weeks for a decision.

3. Continuous or multi-year funding is not available through Beacon's Charitable Donation requests. Programmatic funding may be requested through Beacon's Community Health Outreach department. Contact Amy Estrada @

4. Generally contributions will not exceed $5,000 to any organization in a given year.

5. A copy of your organization's W-9 is required for a request to be considered.

6. Due to the large number of requests received, we can only approve those that meet our guidelines and priorities. Depending on available funds, requests may be declined even if they align with the general criteria.

7. Applicants will be notified of a decision by email.

8. Please direct questions to

Amount Requested *