Family Publicity Form - Aksarben Foundation

Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Height*
Date of Birth*
MM slash DD slash YYYY
Honoree's Email*
Honoree's Phone*
Honoree's Current School or College*
Honoree's Current Grade*
Honoree's Major & Degree*
Honoree's Month/Year of Graduation or Expected Graduation*
Honoree's Past colleges
(If more than one, list years of attended at year)
Honoree's employment and company name*
(if not currently enrolled in school)
Honoree's College Organizations
Honoree's Community Organizations/Position held/ Dates served
Honoree's Special Interests
Publication & Mailing address*
The press release information will be forwarded to the Omaha World-Herald and your hometown publication, if you so choose, following formal annoucement of the Royal Court in August. If you would like this information released to your hometown publication, please name below:
Publication email address*

Father First Name*
Father Middle Name*
Father Last Name*
Mother First Name*
Mother Middle Name*
Mother Last Name*
Mother Maiden Name*
My parents are:*
- Married to eachother
- Divorced
- Married to another
- Widowed
Please specify which parent is married and to whom, if not eachother:
Deceased parent, if widowed
How should honoree’s parents (and stepparents, if appropriate) be listed in print?)*
Immediate family members List: Name of Siblings / Birthdate / Name of School & Grade / Address*
Members of family who have participated in previous Aksarben Balls: Name / Their Role / Date*
Include any family history that may be of special interest*

Father's Email Address*
Father's Occupation (include company name)*
Civic/Professional Involvement/Dates List: Name of Organization / Position held / Dates served*

Mother's Email Address*
Mother's Occupation (include company name)*
Civic/Professional Involvement/Dates List: Name of Organization / Position held / Dates served*

Stepfather's Occupation (include company name)*
Civic/Professional Involvement/Dates List: Name of Organization / Position held / Dates served*
Stepmother's Occupation (include company name)*
Civic/Professional Involvement/Dates List: Name of Organization / Position held / Dates served*
Paternal Grandparents Names*
Paternal Grandparents Address*
Paternal Grandparents Occupations*
Maternal Grandparents Names*
Maternal Grandparents Address*
Maternal Grandparents Occupations*
Phone
This field is for validation purposes and should be left unchanged.