Registration Form for Class of ’63 Reunion

 

Please submit this completed registration form with your payment. 

Name_____________________________________________________

First               Maiden (if applicable)              Last

Occupation__________________ Significant Other_____________

Address___________________________________________________

City/ST/Zip___________________  email_______________________

Phone (Home)______________       (Business)_________________

                       

I     will or will not     be attending the Class Reunion

   (Please circle one)

Please indicate the number of persons for:

Friday                                                    (1) or (2)  @ $17.50 each       $__________

Saturday – Select Entrée Below   (1) or (2)  @ $32.50 each     $__________

Number of Salmon ______ or  Rib Eye_______

(Complimentary Class Directory with Paid Registration)

 

I would like a Class Photo                                  $15 each                  $__________

 

Send me a Class Directory–Won’t be there            $15 each                  $__________

 

TOTAL REGISTRATION (enclosed)                $__________

A confirmation will be sent to you.

 

CLASSMATE SURVEY FORM

 

What’s been happening in your life since the last time we were together?  Since graduation? Your family? Accomplishments to share? (Please limit to 100 words or less). _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

                The Classmate Survey Form must be received by April 30, 2003 to ensure that it will be included in the printed directory that will be distributed at registration of the Class Reunion.

 

                                                                The Class of ’63 Reunion Committee

                                                                P O Box 1400

                                                                N. Sioux City  SD  57049                     

email:  fun4menu@pionet.net                                            Registration Form 63