Thank you for your interest in Eastern Idaho Regional Medical Center’s

Community Action Committee.  The Community Action Committee was

developed to help meet the needs of our community. 

Please refer to the criteria below facilitate submission of your request for funds,

supplies or services.

1. The requesting organization must be “not for profit”.

2. The requesting organization or individual must reside within a 100-mile

radius of Eastern Idaho Regional Medical Center.

3. Preference will be given to requests supporting activities of groups rather

 than individuals.

4. The request must promote, support, and provide recognition to Eastern Idaho

Regional Medical Center.

5. Only one request per year will be honored.

6. The requestor does not have to be affiliated with Eastern Idaho Regional

Medical Center; however Eastern Idaho Regional Medical Center employees

will be given precedence if all criteria are met equally among requestors.

7. The completed Eastern Idaho Regional Medical Center Donation Request

Form must be submitted prior to consideration of the request.  Tax ID number

or social security number of the requesting individual MUST be included

for processing of the request.

Requests must be received by the 15^th of the month or will be deferred until the

following month.

Questions:  Darla Miller @ 208-529-7140.

I understand and agree to the above criteria.