PLEASE USE THIS FORM TO PARTICIPATE
IN THE NEBRASKA ACADEMIC DECATHLON
101 DONATIONS INITIATIVE

Sponsor Name: (Optional) The Name you would like on the Decathlon materials if you are selected as the 101 Donations contest.
     
Donor's Name: (Required if Donor's name is different than the Sponsor's name above.
     
Street Address: (Required)
City, State Zip (Required)
     
Phone Number: (Optional if e-mail address is provided)
     
email Address:   (Optional if phone # is provided.
     
Preferred 101 Donation # (s)             We will contact you for another choice should someone select your number first.
No Preference:            
     
Method:   Please use drop-down to let us know how you will make your donation.
     
Comment or Question:  
     
   
                                          

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