FinalForm77

2017 Classmate Information Form

First Name

Last Name

Please mail this completed form along with your payment to:
LHS Class of 77
c/o 52635 Bamford Dr.
South Bend, IN 46637

Maiden Name

Phone Number

Cell Number

Email

Street Address

City

State

Zip

Employed By

Position

Work Phone Number

Spouse Name

Who Will Know Where You Are In the Next 5 Years?

Contact 1 Name

Relationship

Street Address

City

State

Zip

Phone Number

Email

Tell Us About Your Life. Family, Hobbies, & Some Fun Things For Our Reunion Booklet.

This information is being collected for the sole intention of LHS Class Reunion business, notifying classmates of reunions and preparing a booklet to distribute to attendees.

Please indicate if we can publish your information:

Yes, you may publish my information. No, please do not publish my information.

Will you be attending the reunion?

Yes, I am attending. No, I am not attending.

Guest Name

Number of Attendees:

1 @ $28 2 @ $56