Class of '76 Internal Questionnaire

In order to keep our list of classmates up to date, please fill out this form. The information is strictly for contact purposes only and will not be published!

Though email is our preferred method of contact, email addresses can change. This is especially true if the email we have is from your place of employment. So on the form we have a provision for a second email address. The first one should be the one you'd like as the primary contact. This is the email we'll use on our Google list. Should at any time the primary stop working for us, we'll contact you with the secondary.

But not everyone has a secondary email. So we are also asking you for your phone number(s) and mailing address(es). Again, we only want these to get back in touch if at some point the email we have is not working.

The questionnaire can be entered below and submitted, but we also have a fillable PDF form.  That form can be emailed or mailed to our contact address.

The Questions

Enter your full name as it appeared in the yearbook:


Enter your primary email address. This is the email we'll use for contact. 


Enter a secondary email address if you have one. We will only contact you with this email address should your primary stop working


What is your primary phone number for contact?
    Landline    Cell Phone


If you have one, what is your secondary phone number?
    Landline    Cell Phone


What is your complete mailing address?

Address:  

City:     State:     Zip:    

Country:  


If you have a secondary or seasonal address, enter that here. 

Address:  

City:     State:     Zip:    

Country: