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35th Reunion November 29, 2008
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PLEASE SPREAD THE WORD! Encourage classmates of '73 to Fill in this Form!

Fill in the form below to add your information to our student database.
This information will be used for only two purposes:
1) to send out information about the reunion
2) to compile a new student directory for distribution at the renunion.
_______________________________________________________________

Questions about this form -- Contact Sarah Cominolli-Chauncey by Email or Phone: 845-623-3195.
Send print copy of the information form to: Sarah Chauncey, 34 April Lane, Nanuet, NY 10954

To ADD your information, just fill in the form below and hit the Submit button at the bottom of the form.

To EDIT your information, enter your User ID: Password:
click , make your changes, and then hit the Submit button at the bottom of the form.

* Required Field


* User ID: (max 12)    * Password: (4-10 characters)


* Title(Mr./Mrs./Ms/Dr.):

* First Name: MI: * Last Name:

Maiden Name:

Occupation:

------------------------------------------------------------------------- Family -------------------------------------------------------------

Spouse Name:

Child 1 Name: Age:   Child 2 Name: Age:
Child 3 Name: Age:   Child 4 Name: Age:
Child 5 Name: Age:   Child 6 Name: Age:

------------------------------------------------------------------------- Address / Phone / Email -------------------------------------------------------------


* Street 1:    Street 2:

* City: * State/Province: * Zip/Postal:

* Country:

* Home Phone (nnn-nnn-nnnn):
  
Business Phone (nnn-nnn-nnnn):   Cell Phone (nnn-nnn-nnnn):

Email Address: