Full Name (First,
Last):
Middle Name or Initial:
Last Name in High
School:
Married Name:
Birthdate:
(xx/xx/xx)
Email Address:
Alternate Email Address:
Street Address:
City:
State:
Select one
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington, D.C.
West Virginia
Wisconsin
Wyoming
Zip:
Phone No.:
(Please complete for our records
even if you choose not have to have it published)
Cell Phone No.:
Alternate Phone:
Would you like
us to publish your Email address on the Class Website?
Ask about getting a free
GECLASS86.com e-mail account. You can forward
to your regular e-mail account!
Yes, publish my Email address on the Class Website.
No, do not publish my Email address on the Class Website.
(Please
NOTE If you select YES to publish your e-mail, it
will be encrypted on the website to prevent harvesting)
Would you like us
to publish your street address on the Class Website?
Yes, publish my street address on the Class Website.
No, only publish my city and state on the Class Website.
Would you like us
to publish your phone number(s) on the Class Website?
Yes, publish my home phone number on the Class Website.
Yes, publish both my home and cell phone numbers on
the Class Website.
No, do not publish my phone number(s) on the Class Website.
Would you like us
to publish your Email address in the Reunion Memory
Book?
Yes, publish my Email address in the Reunion Memory
Book.
No, do not publish my Email address in the Reunion Memory
Book.
Would you like us
to publish your street address in the Reunion Memory
Book?
Yes, publish my street address in the Reunion Memory
Book.
No, only publish my city and state in the Reunion Memory
Book.
Would you like us
to publish your phone number(s) in the Reunion Memory
Book?
Yes, publish my home phone number only
Yes, publish both my home and cell phone numbers.
No, do not publish my phone number(s) in the Reunion
Memory Book.
Are you planning on
attending the 20 year reunion?
Yes
No
Maybe
Will you be bringing
a guest?
Yes
No
Maybe
Will you be requiring
hotel accomodations (this will help us to calculate
number of rooms to block off at hotel(s)?
No
Fri Only
Sat Only
Fri and Sat
Check the reunion
weekend activities that you are interested in attending.
(Select all that apply):
Fri: Welcome home tailgate reception
Fri: Tour of school
Fri: Homecoming game
Fri: Mixer after Homecoming Game
Sat: Golf Outing
Sat: Breakfast buffet
Sat: Reunion Gala Dinner Dance
Sun: Farewell Champaign Brunch
What is your marital
status?
Single
Committed
Engaged
Married
If married, how many
years?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
Date of marriage:
(xx/xx/xx)
If married, committed
or engaged, please enter spouse or partner's Name:
Spouse's high school
and graduation year:
If you have children
how many do you have?
0
1
2
3
4
5
6
7
8
9
10
If you have children,
what are their names and ages?
Number of grandchildren,
(if applicable):
0
1
2
3
4
5
Upload a current photo
for the "Then and Now" page. (headshots or closeups
are best with only you in the photo):
Upload a photo of
your family:
Add a photo caption
(i.e.Suzie and Jim at the beach):
Upload another photo:
Add a photo caption:
Colleges/universities/trade
schools attended:
Degree(s) or Certification(s)
received:
Military service (branch,
years):
Current occupation
or job title:
Current employer:
Brief job description:
Future goals:
Highpoints of your
life since high school?
What are your memories
of high school (i.e. secret crush, embarrassing moment,
funniest thing you did in high school, favorite high
school hang out, favorite teachers)?
If you could go back
to high school for one day what would you change or
do differently?
Which was your favorite
song or performer in high school?
Which is your favorite
performer or song today?
Places you've lived:
Places you've traveled:
What are your hobbies
and interests?
Message(s) you'd like
to post for fellow classmate(s)?
Did you attend the
10 year reunion?
Yes
No
*Some of this personal
information may appear in the 20 Year Reunion Memory
Book and on our class website. If you do not wish for
us to include this information, please change this to
no.
Yes, Publish
my info
No,
Please do not publish my info