Sponsorship Request Form

This form is used to request that Molina Healthcare of South Carolina sponsor your:

Upcoming event

Campaign/Initiative

Corporate/Statewide sponsorship

Yes No

* Denotes Required Fields.

Volunteer Opportunities

Submitted Successfully

Please complete required questions and resubmit
Please enter a 10 digit telephone number
Please enter a valid Zip code


Please submit any additional documents to SCSponsorshipRequest@MolinaHealthcare.com. In approximately 4 weeks, you will receive a reply to your request.


By submitting my information via this form, I consent to having Molina Healthcare collect my personal information. I understand and agree that my information will be used and shared in accordance with Molina Healthcare's Privacy Policy and Terms of Use.