Make your own free website on Tripod.com

     Last name           First name

    Maiden name   Married            Single   

     Spouse's name

    Address
    Home PhoneCell Phone
    Email address:

    Would you give permission to share this information through directory mailout or
    emailed  newsletter?  Your information will NOT be published on the 
    internet
at any time.
                                                  yes  no
                        

           Please include comments, suggestions, info on classmates, or anything else
        you'd like:

SPECIAL NOTE:  DEPENDING ON YOUR BROWSER, YOU MAY NOT BE ABLE TO SUBMIT THE FORM DIRECTLY, IF AN EMPTY EMAIL BOX APPEARS, PLEASE RE-TYPE THE INFORMATION IN THE EMAIL WINDOW.  WE APOLOGIZE FOR THIS INCONVENIENCE. 

Home