Would you like to nominate a child that you think would benefit from our organization? Just right click on the form below and select print. Fill out the form and send to:
Sports for Kids Foundation P. O. Box 4 Scribner, NE 68057
(Back to Recipients)
Name of child:___________________________________Age:___ Address:_______________________________________________ City:____________________State:______________Zip:_________ Condition or diagnosis:___________________________________ _______________________________________________________ Item/s requested:________________________________________ _______________________________________________________ Cost of each item:________________________________________ _______________________________________________________
Describe how the item/s will assist this person: (You may attach a separate statement or narrative to this application) _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________
If approved, make check payable to:____________________________________________________ Address:_______________________________________________ _____Permission granted to Sports for Kids Foundation to use name and photo. Return to: Sports for Kids Foundation P. O. Box 4 Scribner, NE 68057
Additional copies may be made for multiple nominations.