Amgen is dedicated to making the application process simple and straightforward. It is a two step process with important deadlines and criteria for requestors to meet.

1. Complete online form
2. Submit your printed form along with your supplemental documents 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

Amgen will send an email confirming the receipt of your application once the printed online form and supplemental documents are received.

Amgen commercial staff, including field staff, are not involved in decisions to fund healthcare donations.

For any questions regarding the application process or supplemental documents, please contact 1-866-44AMGEN (1-866-442-6436).

Donation Application Requirements

Amgen’s healthcare donation funding application process includes:

1. Completion of an online form AND
2. The submission of supplemental documents along with your confirmation of the online form.

Please ensure that your supplemental documents are sent to Amgen within 30 days of submission of your online form. Failure to timely submit all of the required documentation could result in a denial of your funding request.

Explanation of Required Supplemental Documents for Donation Funding Consideration

In order to ensure the funding request is processed in a timely manner, all items listed below must be completed and sent to Amgen.

1. Confirmation of online form (printed upon completion of form)
2. Detailed Description of Program
   • Organization’s mission and purpose
   • Program Name and Date
   • Specific Program Description and Objectives
   • Identification of Audience
3. Detailed Funding Requirements
   • Statement regarding how funds will be used
   • Check Payable to Name
   • Complete Address and Telephone Number
   • Tax Exemption Status
   • Taxpayer ID Number
4. Completed W-9