Please join

THE NEBRASKA REPUBLICAN PARTY

for a

SALUTE TO DUANE ACKLIE

with featured guest
KARL ROVE

Date: Friday, June 11, 2010

Time: VIP Social Hour 5:30 – 6:30 p.m.

Dinner & Program 7:00 – 8:30 p.m.

Location: Embassy Suites (Windsor Ballroom)

12520 Westport Parkway
La Vista, NE 68128

Contributions: $5,000 Table Benefactor (Photo Opportunity ~ VIP Reception ~ Premier Seating for 10 ~ Table Listing)
$1,500 Couple Benefactor (Photo Opportunity ~ VIP Reception )
$1,000 Individual Benefactor (Photo Opportunity ~ VIP Reception)
$2,500 Sponsor Table of 10 (Premier seating for 10 ~ Table Listing)
$500 Host
$250 Patron
$100 Attendee
*All contributions of $250 or more receive listing on invitation and host board, and signed copy of Karl Rove’s “Courage and
Consequence”

For the Salute to Duane Acklie, please list me as a: _____ $5,000 Benefactor Table of 10
_____ $1,500 Benefactor Couple / _____ $1,000 Individual
_____ $2,500 Sponsor Table of 10
_____ $500 Host
_____ $250 Patron
Name listing on invitation and host board ___________________________________________________________________________________

_____ Yes, I will attend the reception for a contribution of $100 per person. ______ seat/s @ $100 each = $ __________.00

_____ No, I am not able to attend the event 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