Please complete and return this form six (6) months before your proposed event or initiative. Only complete forms will be taken under consideration. Until a confirmation is received, contributions should not be solicited and the name Siteman Cancer Center should not be used for any purpose. Siteman Cancer Center may withdraw approval at any time should we discover inappropriate messaging or behavior associated with the event. The event host will be notified of the approval withdrawal in writing. After approval is withdrawn, all references to Siteman Cancer Center, and related departments and programs must be eliminated. If you have any questions, please contact Brandy Meyer at firstname.lastname@example.org or (314) 935-2993.