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About
Program
Nominate a Camper
Support

Nominate a Camper!

Fill out the short form to nominate a student. We’ll follow up with an application and the specific opportunities that they can participate in.

1 About the Youth

2 Parent Contact Info

Nominee Name*
First Last
Nominee Age/Grade
Current age and grade if known
Gender Identity
If you are unsure how the youth identifies, you can leave this option blank.
Tell us more about them!*
Why do you think they would enjoy or benefit from our program? Do they have any outdoor experience or interest? Include any information that you think we may need to know including behavioral issues, medical considerations or other. We do our best to accommodate every student.

Parent/Guardian Contact info
Parent or Guardian Name
First Last
Parent or Guardian Email
Parent or Guardian Phone
Are you the parent or guardian listed above?
- Yes
- No
About You!
We won't contact you unless we have follow up questions or difficulty getting ahold of the youth through the other information provided.
First Last
Your Email
Phone
Tell us about your relationship with the youth.
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Mailing address: P.O. Box 641609 Omaha, NE 68164-1609 | Executive Director, Ian Kimmer Phone: 218-750-0784 | Email: Ian@GoBeyondNE.org

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