Corporate Support
(CS) Grant

About CS Grants
Application Form

Neurocrine is dedicated to furthering the goals of various professional, charitable, educational, and patient-focused organizations. In accordance with applicable laws and industry codes of conduct, Neurocrine provides funding and support in the form of sponsorships, charitable contributions, and independent medical education (IME) grants.

Areas of Interest

Organizations focused on advancing science and/or advocating for patients and families within therapeutic areas relevant to Neurocrine.

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Required Documents

Letter of request on the requesting organizationʼs letterhead specifying:
- The amount of funds being requested
- The recipient of the funds (eg, conference secretariat, if applicable)
- How the funds will be used, along with a general expense breakdown
Detailed description of project or program for which the support is being requested (eg, scientific program, conference schedule, prospectus)
Copy of the W-9 form for the recipient of the funds
- Foreign organizations must provide a copy of the W-8BEN-E for the recipient of the funds

Evaluation Criteria

Sponsorships must not be based on or linked to the prescribing, formulary, purchasing or reimbursement policies or practices of any institution
Organization must have an open membership policy and information about the organization should be publicly available or available upon request
Sponsorships cannot be made to or on behalf of individual Healthcare Professionals (HCPs) or group practices
Sponsorships may not be used to pay the cost of entertainment or recreational activities or to compensate for time spent at meetings by attendees. In addition, sponsorships may not be used to cover a capital or operating expense for the requesting institution or an HCP

Hidden
Submission ID
First Name*
Last Name*
Organization Name*
Phone Number*
Email Address*
Hidden
Tax ID Number - legacy
Title of Program*
Program Start*
MM slash DD slash YYYY

Date Format: MM slash DD slash YYYY
Program End*
MM slash DD slash YYYY

Date Format: MM slash DD slash YYYY
Location of Program*
Anticipated # of Attendees*
Enter N/A if your request is for a membership or partnership program.
Would NBI be sole funder of program?*
- Yes
- No
Amount of Funds Requested (USD)*
Attach Documents
Hidden
Attach Documents
Drop files here or

Max. file size: 100 MB.
Letter of Request*
Drop files here or

Max. file size: 100 MB, Max. files: 1.
Description of program*
Drop files here or

Max. file size: 100 MB.
Tax Form (W-9 or W-8BEN-E) for the recipient of the funds*
Drop files here or

Max. file size: 100 MB, Max. files: 1.
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What is the program's agenda? If you have a brochure or document explaining your program in more detail, please attach it below. - legacy
Please specify how sponsorship funds will be used if your request is approved. Refer to Evaluation Criteria for more information.*
Please add any additional information that may facilitate the review of your request.

Need to get in touch with us?

grants@neurocrine.com

Corporate Support (CS) Grant