EHS CLASS OF 1989 REUNION

ATTENDANCE REGISTRATION INFORMATION

 

PLEASE COMPLETE THIS REGISTRATION INFORMATION AND MAIL ALONG WITH YOUR CHECK OR MONEY ORDER PAYABLE TO "EXETER HIGH SCHOOL CLASS OF 1989" TO:  Derek Liporto, 130 Coleman Road, Auburn, NH  03032.

 

(Please Print)

First Name

 

Last Name

 

Maiden Name

 

 

 

 

 

Mailing Address

 

Home Phone #

(Street)

 

 

(City)                                                                    (State)                       (Zip)

 

 

Email Address

 

Cell Phone #

 

 

 

First and Last Name of your guest

 

Relation of guest to you 

 

 

 

Is your payment enclosed?

 

Total $ Amt. Enclosed*

                                      YES    NO   (circle one)

 

 

Do you want the information you provided above to be available to other classmates?

YES     NO   (circle one)

Please identify any music/song requests that you would like to hear at the event?

(Band Name)                                                                        (Song name)

(Band Name)                                                                        (Song name)

(Band Name)                                                                        (Song name)

(Band Name)                                                                        (Song name)

(Band Name)                                                                        (Song name)

 

*The per person cost is $30.00 if payment is received before October 31, 2004.

*The per person cost is $45.00 if responding after October 31, 2004.  Sorry, but we can not

  guarantee entry to this event if payment isn't received before November 12, 2004.