Amgen’s healthcare donation funding application process includes an online application form and the submission of supplemental documents. Please prepare the requested supplemental documents prior to beginning the online application.

Each items listed below must be completed and submitted by a qualified recipient.

Explanation of Required Supplemental Documents for Healthcare Donation Funding Consideration

Requests must be accompanied by a Letter of Request (LOR) from funding applicant.

1. Letter of Request must be:
   • Signed & dated from the requesting organization on requesting organization’s letterhead
   • Addressed to Amgen
   • and include:
   • Program Name and Date
   • Specific Program Description and Objectives
   • Amount Requested
   • Statement regarding how funds will be used/budget breakdown
   • Check Payable to Name
   • Complete Address and Telephone Number
   • Taxpayer ID Number
   • Identification of Audience
2. Current W-9 form
3. Copy of IRS tax-exempt status determination letter

 Overview of Healthcare Donation Funding Application Process

1. Start online application form
2. Enter application form online
3. Print application form
4. Combine printed application form with required supporting documentation (see above)
5. Submit your supporting documents and the printout of the online application form to Amgen by:

   Email to: HCCDonations@amgen.com.

   OR Fax to: 1-888-272-5510

   OR Mail to:

   Amgen
   Attn: HCC Healthcare Donations
   One Amgen Center Drive, M/S 27-3-A
   Thousand Oaks, CA 91320
   

For any questions regarding the application process or supporting documents please contact 1-866-44AMGEN (1-866-442-6436.) If you’re ready to begin the donation application process, click the Start button below.