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Application & Form Instructions

We accept forms/applications in 3 different ways click on the method you wish to find more information.

  • Mail
  • Fax
  • Email

***Please note: You may lose your work if you don’t open the application using adobe reader. You can download Adobe Reader for Free Here.***


 

Mail:

Mail to:

ATTN: Alisha Schroeder
1203 E Hynes
O’Neill, NE 68763

Please send your application via email or call us at (402) 961-1358

If you do not have adobe reader you can download it here: https://get.adobe.com/uk/reader/?promoid=KSWLH


 

Fax:

Please fax the filled out form/application to 402-261-3963

If you do not have adobe reader you can download it here: https://get.adobe.com/uk/reader/?promoid=KSWLH


 

Email:

Please send the filled out form/application to administrator@countrylaneretirement.com

If you do not have adobe reader you can download it here: https://get.adobe.com/uk/reader/?promoid=KSWLH


 

Downloading and Filling out the eForm/application:

Instructions for filling out the eform/application:

  1. Download the application/form by clicking on the download link.
  2. Open the document using adobe reader (see instructions below if you have troubles). If you do not have adobe reader you can download it here: https://get.adobe.com/uk/reader/?promoid=KSWLH
  3. Fill in the form/application.
  4. Go to file > save as and rename the document with your name.
  5. Now you can print it out and mail/fax it to us or attach it in an email.

***Please only use Adobe Reader to fill out this form. You can see if you are using Adobe by looking at the top of the form/application, it should say Adobe Acrobat Reader.***