Name
Street Address
City
State/Province
Zip/Postal Code
Country
E-Mail Address
Telephone Number
FAX Number
Married? Yes No
Spouse's Name
Current Occupation
Children with Ages:

Grand Children with ages:

Are you attending reunion? Yes No
When? All Weekend Friday only Saturday-Dinner and Dance Dance only

If not attending would you like to purchase:
Yes No Reunion T-shirt
Yes No Reunion "Year Book"
Yes No Class Picture
(Also if not attending please send a photo of yourself or yourself with companion to Brenda Franks for the reunion book)

Yes No Do you need a place for children to stay while attending reunion?

Is there anything that you would like to do or see while back in Mountain Home??


Please tell us what you have been doing the last 25years since you left High School. (jobs, awards, families, special events, achievment,ect)

Is it OK to publish this information on a special page on the internet with other classmate information Yes No

Thank You!
You can contact me best by: EMail Telephone, Voice FAX

Before submitting this form, please be sure you have filled out all necessary information for us to contact you!


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