Name (First Name MI (Maiden Name) Last Name):
Your Preferred Name:
Home Street Address:
Home City/Town:
Home State/Country:
Home Zip/Country Code:
Home Phone Number ((987)654-3210):
Cell Phone Number ((987)654-3210):
Other Phone Number ((987)654-3210):
Spouse/Friend (First Name MI (Maiden Name) Last Name):
Spouse Phone Number ((987)654-3210):
Bringing Spouse/Friend to Reunion (Y/N)?
Favorite Pastime (Movies, Reading, Sleeping)?
Hobbies (Crafts, Fishing, Skating, Tennis)?
Preferred Time of Year for Reunion (Month/Season)?
Reunion Activities (Cruise, Dancing, Hors d'oeuvre, Buffet, Picnic)?
How Often Should We Have a Class Reunion (1-10 years)?
Choose Your Preferred Dates from these Choices (Apr 29-May 2, May 13-16, Sep 16-19 or Sep 22-25, 2015)?
Would You be interested in Small Local Reunions (Y/N)?
Would you Like to be Put in Our Memory Book (Y/N)?
Do You/Spouse/Friend Have Any Special Food Restrictions?
Would You be Interested in Combined Reunion (Y/N)?
Which Class for a Combined Reunion with (1963, 1964 or 1966)?
Were You a Doctor, Fireman, Nurse, Occupation, Policeman, Served In or Teacher?
Your Personal Website:
Your E-mail:
Comments:
Please Do Not enter URL address!
