Jacobs’ Place

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Branching Out Admissions Form

Please complete this form if you are interested in participating in our Branching Out Independent Living Program. After submitting the form, a staff member will be in touch with you.

Email

This field is for validation purposes and should be left unchanged.

Demographics

Name(Required)

First Last

Gender

DOB(Required)

Age(Required)

Phone Number(Required)

Email(Required)

Current Address(Required)

Street Address City State ZIP Code

Parent/Emergency Contact Information

Parent/Emergency Contact Name(Required)

First Last

Parent/Emergency Contact Phone Number(Required)

Parent/Emergency Contact Email(Required)

State Ward Information

MC#

DHHS Worker

First Last

DHHS Worker's Phone Number

DHHS Worker's Email

Probation Officer

First Last

Probation Officer Phone

Probation Officer Email

Applicant's Goals

What are your goals in the following three areas

Employment Goals(Required)

Education Goals(Required)

Independent Living Skills Goals(Required)

Sponsorship Opportunities

OHB Golf Classic sponsorships are a great way to showcase your
business while also supporting the youth and families at OHB.

All Sponsorships Include:

All-in-One Band Package (5 mulligans per team, 5 raffle tickets per team, move up hole, pick your pin)
Recognition at the banquet
Sponsorship signage
Name/logo recognition on OHB.org event landing page

PRESENTING (1) – $5,000
Industry Exclusive Presenting Sponsor

Three golf foursomes
Information table on a hole
Social media recognition
Logo on all digital media event promotion
Premier logo placement on OHB.org event landing page
Logo on post-event thank you letter
Logo on golf cart and pin prize signs

PHOTO EXPERIENCE (1) – $2,500
Exclusive Photo Experience Sponsor

One golf foursome
Information table on a hole
Logo on all photos from the photo booth experience

AIR CANNON SPONSOR (1) – $2,500
Exclusive Air Cannon Sponsor

One golf foursome
Signage with company logo on air cannon hole
Information table and company tent at air cannon hole

COURTESY CART (3) – $2,100
Exclusive Courtesy Cart Sponsor

One golf foursome
Signage with company logo on all courtesy carts
Information table on a hole

DRIVING RANGE (1) – $1,600
Exclusive Driving Range Sponsor

One golf foursome
Signage with company logo at the driving range
Information table on a hole

PUTTING GREEN (1) – $1,600
Exclusive Putting Green Sponsor

One golf foursome
Information table on a hole
Signage with company logo at the putting green

BEVERAGE CART (2) – $1,600
Beverage Cart Sponsor

One golf foursome
Signage with company logo on all beverage carts
Information table on a hole

REGISTRATION (1) – $1,600
Exclusive Registration Sponsor

One golf foursome
Signage with company logo at the registration table
Information table on a hole

DRINK TICKET (2) – $1,600
Drink Ticket Sponsor

One golf foursome
Information table on a hole
Your logo on drink tickets for every golfer
Signage with company logo

EAGLE – $1,100

One golf foursome
Teebox sponsorship signage

BIRDIE – $500

Teebox sponsorship signage

Questions?
For more information on sponsorships, registration, volunteering or pin
prizes, contact Kelsey Ridder at kridder@ohb.org or 402.457.7014

Jacobs’ Place

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