Wp Form 129 - Nebraska Holiday Brochure Profile Form
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2Nebraska Holiday Brochure Profile Form
If your company sells gift baskets, gift boxes, gift crates, or other uniquely packaged food products, and you would like to be
listed as a supplier of gift item(s) in a Nebraska Department of Agriculture holiday brochure, please complete this form and
return it to the Nebraska Department of Agriculture by July 23, 2010. You will be included in a brochure listing the availability of
specialty packaged Nebraska food items that are for sale to the general public by Nebraska food and meat companies. If you
have questions, please call 800-422-6692.
Do you wish to be included, at no cost, in our brochure and on the web site?
Yes
No
Company name
Contact name
Address
City/state/zip
Telephone (include area code)
Toll free
E-Mail address:
Web site address:
If company's head office is located in another state, who would be the Nebraska plant contact person?
Nebraska address
City
NE
Zip
Please describe products and packaging exactly as you wish it to be printed in the holiday brochure:
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________
PRODUCT AVAILABILITY (check all that apply)
Year-Round
Thanksgiving
Christmas
New Year
Other (please list): ____________________________________
PRODUCT PACKAGING (choose all that apply)
Gift baskets
Gift boxes
Gift crates
Other (please list): ___________________________________________________
WP Form 129 (08/05)
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