Is your agency coordinating this event?YesNo
Name of Event
Date of Event
Time of Event
Location of Event
Brief Description of the Event
Amount of Sponsorship Requested: (Amount not to exceed $300)
Check made payable to
Please describe specifically how the funds requested will be used.
Please describe how these funds will be used to benefit the HIV/AIDS community and meets a public purpose.
Has your agency received funding from Bexar County in the past 12 months?
If yes, what sources of funding from Bexar County have you received? Check all that apply.
General FundCommunity Development Block Grant (CDBG) Public Service FundsBexar County RX Card