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In-Kind Donation Form

This form is used to request that Molina Healthcare of South Carolina provide donations of services or goods.

*Denotes Required Fields

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*Describe the organization’s mission:
*List the counties the organization serves:
* Describe the audience and the population(s) it serves:
*Describe the organization’s donation needs (please include the date needed by and quantities, if applicable):
*Describe what the in-kind donations will be used for. Please be specific:
*Describe any logo or marketing requirements and deadlines:
*Note any special needs or requests not mentioned above:
Volunteer Opportunities
Through Helping Hands, Molina Healthcare’s employee volunteer program, Molina employees are encouraged to give back to the community. Helping Hands offers employees paid-time off to do direct volunteer work with local organizations such as homeless shelters, after-school programs and food pantries. Please describe any potential volunteer opportunities with your organization:






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

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