2026 Omaha Day Without Shoes Registration Campaign Dates: April 6th - April 19th

Event Participation

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* 1. Company Contact Information

Company

Address

City

State

ZIP

Email Address

Phone Number

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* 2. Contact name:

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* 3. There are 2 options for participating in the shoe collection as a drop-off site. Please select your preference:

Would you like the Stephen Center to deliver your receptacle or would you like to use your own?

We would like our receptacle delivered to our organization. Receptacle delivery week of March 30th.

We have our own shoe collection receptacle.

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* 4. Once the campaign has ended, would you like the Stephen Center to pick up your receptacle or would you like to deliver it the week of May 6th?

We would like our receptacle PICKED UP the week of April 20th.

We would like to DELIVER our receptacle the week of April 20th.

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* 5. There are many ways to partner with us for this event. Please mark all the ways your organization would like to get involved to ensure you are recognized for your participation.

Collect shoes at my organization.

"Sell" paper feet for a donation to the Stephen Center for the duration of the shoe drive. How many would you like?

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* 6. How did you hear about this event?

Our organization has participated before.

We saw it on Cornhusker Bank Marketing. (social media, emails, website, busses, etc)

We saw other businesses participating and wanted to support the community as well.

A friend, client, family or bank associate referred us. (Please list their name. We'd like to thank them!)

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* 7. Special requests or instructions for:

Cornhusker Bank

Stephen Center

Two Men & a Truck

Request/Instruction:

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* 1. Company Contact Information

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* 2. Contact name:

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* 3. There are 2 options for participating in the shoe collection as a drop-off site. Please select your preference:Would you like the Stephen Center to deliver your receptacle or would you like to use your own?

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* 4. Once the campaign has ended, would you like the Stephen Center to pick up your receptacle or would you like to deliver it the week of May 6th?

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* 5. There are many ways to partner with us for this event. Please mark all the ways your organization would like to get involved to ensure you are recognized for your participation.

Question Title

* 6. How did you hear about this event?

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* 7. Special requests or instructions for:

* 3. There are 2 options for participating in the shoe collection as a drop-off site. Please select your preference:

Would you like the Stephen Center to deliver your receptacle or would you like to use your own?