Membership Application
Individual $20 Couples $30 Booster Club $150
New Renewal Advertiser $200
Additional Donation to assist the LVN $ _______

Booster Club and/or Advertiser includes your Individual/Couple Membership

(Your) Last Name: _______________________ First: ____________________
(Spouse/Other) Last Name: _______________________ First: ____________________
 

Please fill out all info: (We need to update your current address, phone, and email info) Thanks.

 

Address: _______________________________________________________________________
City: ___________________________ State: _____ ZIP: ____________
Telephone: ____________ Cell: ____________ E-mail address: ________________________
 

YOU
Occupation: ______________________________
Type of Business: __________________________
Business Name: ____________________________
Hometown: _______________________________
College/Univ Attended: ______________________
SPOUSE/OTHER
Occupation: ______________________________
Type of Business: __________________________
Business Name: ____________________________
Hometown: _______________________________
College/Univ: ______________________________

FOR ALL MEMBERS: PLEASE UPDATE this section for the current Club Year:

 

Member of the U. of Nebraska Alumni Association? Yes ___ No ___  If yes, Annual___ or Lifetime___


I/We would volunteer to assist with the fund-raising (raffle ticket sales and tee-shirt sales) at a Huskers TV game at Bentley's Bar.  The proceeds benefit our Scholarship program for Las Vegas students that attend college in Nebraska. Also, our local charitable contributions including Operation School Bell.
Privacy Statement
Las Vegas Nebraskans will take appropriate measures to safeguard the personal information shared with us.

 

Make Checks Payable to: Las Vegas Nebraskans  
Mail to: Judy Hetherington, LVN Membership
2921 Whalers Cove Circle

Las Vegas, NV 89117

More Information. Judy Hetherington, Membership Chairperson (702) 525-6443 (cell)
lasvegasnebraskans.com (click on membership)

or LVN Hotline 702-223-6992.