Project Celebration family nomination

Thank you for nominating a family for Project Celebration, a program providing free birthday parties (and other perks) for children being served through human service organizations in Lancaster County, NE. Once received, staff will assess available parties and funding and will contact the person nominating to confirm or deny the request.

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* 1. Contact info for person submitting nomination

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Month nominated child has a birthday

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* 3. If selected I will get permission from the family to disclose their contact information with LCM staff.

Yes

No

Other (please specify)

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* 4. As the nominator, I am willing to be interviewed/share information for promotion of this program.

Yes

No