NCHS Class of 1965 Information and Reservation Sheet

Please complete by July 12, 2010 and "Submit" this form, or print it and fax it to 815-425-0277,
       or print it and send it by US Mail to: NCHS Class of 1965, 19 Brompton Ct., Bloomington, IL 61704

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June 30, 2010:
If you are a member of the NCHS Class of 1965, you should have received a letter in the US Mail
   with a printed version of this form. If not, please e-mail us.
We are having trouble receiving submissions from Microsoft Outlook Enterprise and Windows-7 Mail,
   and possibly other e-mail programs.
We recommend that you print your completed form before submitting.
If you do not receive a confirmation message after clicking "Submit", your form was not sent,
   and you will need to print it and send it by fax or US Mail.
Feel free to contact us at the e-mail address below with any questions, comments, or frustrations.
Questions? E-mail us at nchs65@ameritech.net at any time.


 Much of the following information will be included in our 2010 Reunion Directory.

Last name in high school   First name    Classmate Middle Initial 
          Last Name you currently use (if different)    
Spouse's first name    Middle Initial   Spouse's  last name (if different than yours)   
          Spouse's hometown and state     
Your mailing Address  City   State   Zip
            Country if other than US
Home telephone Work or mobile telephone (optional) E-mail address

Name and address / telephone / e-mail of someonewho could help us locate you in the future
  

 Occupation Retired ?

Tell us more about your life, including spouse, children, grandchildren, work, retirement, hobbies, travel, etc.
You may attach recent photo(s) to the "Submit" e-mail message, or send them by US Mail, for display at the reunion or to be added to our website;
Mailed photos are not returnable.
If you are unable to "submit" this form, please print it and fax or mail it;
If you print it and your comments won't fit, please continue comments on an extra sheet.
Your comments may be edited in the Reunion Yearbook because of space limitations.
 

Reserve a place for at only the reunion dinner, Friday, August 20           $
Please include payment of $40 per person. (Do not select this option if you are attending both events.)
My Dinner entree selection Guest Dinner entree selection
Reserve a place for at only the reunion reception, Saturday, August 21   $
Please include payment of $20 per person. (Do not select this option if you are attending both events.)
Reserve a place for at both the dinner and reception, August 20-21         $
Please include payment of $60 per person. (Select this option if you are attending both events.)
My Dinner entree selection Guest Dinner entree selection
Send me a copy of the Reunion Yearbook
(Note: one copy is already included with a reception or dinner reservation.)                                                     $
Please include payment of $10 per copy, Yearbook will be sent postpaid.
(Do not select this option if you are attending either the Dinner or Reception.)
Send me a copy of the class group photo to be taken at the August 20 Dinner
Please include payment of $15 per copy, photo will be sent postpaid.                                        $

Total payment due                                                                                                                   $

Please mail your check or money order to NCHS Class of 1965, 19 Brompton Ct., Bloomington, IL 61701.
Please make it payable to "NCHS Class of 1965".  Please do not send cash.
We are required to pay the Marriott and Davis Lodge in advance, so checks and money orders
    must be received by July 12, 2010.
We will be unable to hold reservations if we do not receive your payment.
Due to our advance payment requirements, we are sorry that we will be unable to accept "walk-ins" at either event.

If you wish to make a donation to the scholarship fund, please send a separate check
  payable to "NCHS Class of 1965 Scholarship Fund"
Guest's name for name tag



Do you have any other comments for the Reunion Committee:
           
 

We recommend that you print this form before clicking "Submit".

               If you are unable to "Submit" this form, please print a copy and mail to NCHS Class of 1965, 19 Brompton Ct, Bloomington, IL 61704.
In addition, please e-mail the webmaster at NCHS65@Ameritech.net at any time and explain the problem that you encountered when trying to submit.
Thank you.


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