Donation Form
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Mission Statement: The Founda4on advances
opportuni4es for quality educa4on services in
Nebraska-based ins4tu4ons.
Vision Statement: Improving quality of life;
fulfilling one dream at a 4me.
Donor Informa4on (please print or type)
Name
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Mailing Address
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City, ST Zip Code
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Phone #1 | Phone #2
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Email Address
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Dona4on Informa4on
I!(we)!donate!a!total!of!$____________________!to!be!paid:!check!online.!
Gift!will!be!matched!by!(com pany/family/foundation)!! !
form!enclosedform!will!be!forwarded!
Please!use!my/our!donation!to!support:!
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Acknowledgement Informa4on
Please!use!the!following!name(s)!in!all!acknowledgements:!! !
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I!(we)!wish!to!have!our!gift!remain !anonymous.!
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Signature(s)
Date
Please!make!checks,! corporate!matches,!or!other!gifts!payable!to:!
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CENTRAL(COMMU NITY(COLLEGE(FOUNDATION(
201(Foundation(Pl(Ste(200(
Has%ngs, NE 68901-4014
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