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Click on Submit when ready to send.
If you have an trouble completing and submitting this information, you can always call or send a regular email.
Complete Name in School
Verify Email Address
Your Mailing Address
City, State & Zip Code
Home Phone Number
Date of Birth (YYYY-DD-MM)
Who will always know how to reach you? (Name, Phone & Email)
Date of Reunion
The above information will be accepted as your registration if you haven't already registered.
Please list your requests in the boxes below, by "Song Title" and "Artist" if you know both.
(Please list your requests in order of importance, as I might not get to all requests.)
If you have special dedications or occasions you would like annouced with your request, please notate in box provided.
Special dedication or announcement requests
Thanks for your donation to the