This form is ONLY for scholarship supporters who forgot their Password. Passwords that were used prior to January 10, 2011 can no longer be used. Please "
click here
" to see how to make your donation and get a Password for access to some special parts of the webpage.
If you have never registered
CLICK HERE
for REGISTRATION FORM,
or your completion of this form will be used as your registration, but you will not receive a Password just by submission of this form.
(
Use Tab Key or Mouse, ENTER Can Prematurely Submit Form
)
Year Your Class Graduated
Complete Name when at HHS (First-Middle-Last)
Your Present Name
Your Email
Repeat Your Email to Verify
Your Mailing Address
City - State - Zip Code
Home Phone
Birth Date (YYYY-MM-DD)
Who will always know where you are? (Name, Phone & Email)
All Entries Must Be Made for Form to Submit
Please accept my apology for any inconvenience and
thanks for your support!
CHARLEY BLACKMORE
573-442-1873
charley@kewpie.net
**
Thanks for your donation to the
,
kewpie.net Scholarship
.**