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Mail In Form


Roosevelt Class of 1980 Registration FormVersion 1.0  2/20/10


Name:
 

Name of RHS Classmate (if different): 
 

Address1:
 

Address2:
 

City:
 

State:
 

Zip:
 

Primary Email:
 

Secondary Email:
 

Number Attending:  1 / 2 / Other

Friday Night:   Y / N

Saturday Night: Y / N

Sunday Afternoon: Y / N