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THE NEBRASKA REPUBLICAN PARTY

HALAPALOOZA
NEGOP Roasts The Honorable Hal Daub
Date: Friday, October 1, 2010

Time: 6:30 – 8:30 p.m.

Location: Omaha Country Club


6900 Country Club Road, Omaha

Contributions: $5,000 HALlelujah (table of 10)


$2,500 HAL of a gift (table of 10)
$1,000 HALlmark Couple
$500 A little DAUB will do ya
$50 Attendee / $100 Couple

Contac t Rebecca: Listing on Invitation – Deadline September 8th


Listing on Event Host Board – Deadline September 29th

For questions or more information, contact Rebecca Weber at 402-475-2122 or rebecca@negop.org

For HALapalooza, please list me as a: _____ $5,000 HALlelujah (table of 10)


_____ $2,500 HAL of a gift (table of 10)
_____ $1,000 HALlmark Couple
_____ $500 A little DAUB will do ya
_____ $50 Attendee / _____ $100 Couple
Name listing on invitation and host board ________________________________________________________________________

_____ Yes, I will attend the reception for a contribution of $50 per person. ______ seat/s @ $50 each = $ ________.00
_____ No, I am not able to attend the reception but please accept my contribution of $__________.00.
Name: _______________________________________________________________________ Phone: ________________________________
Address: _____________________________________________________________ City:______________________________________
State: _______ Zip: ___________________ Email: _______________________________________________________________________

_____ Visa _____ Mastercard _____ Discover CC #: ________________________________________________________________

Exp. Date ____/_____ Sec. code: _______ Signature: ____________________________________________________


Make checks payable to: The Nebraska Republican Party ~ 1610 ‘N’ Street ~ Lincoln, NE 68508.
Contributions are not deductible for Federal Income Tax purposes. Contributions by foreign nationals are prohibited.
Federal Law requires us to collect and report the name, mailing address, occupation and name of employer for each individual whose contributions
exceed $200 in a calendar year. Please provide the following:

Occupation: ___________________________________________________ Employer: __________________________________________

Paid for by the Nebraska Republican Party. Not authorized by any candidate or candidate’s committee. 1610 N Street, Lincoln, NE 68508 www.negop.org

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