Contact Submittal Form
(Mail Version)
CONTACT INFORMATION
NAME:
First_______________ Middle ________________ Last ____________________________
Maiden Name
______________________________
Street Address ____________________________________
City ______________________ State _____ ZIP _________
Home Phone (_____) ________________________ Cell Phone
(_____)_________________________
E-Mail _______________________________ Your Birthday
_________________________________
Where did you attend: Junior High
___________________________________
Elementary
___________________________________
Do you want your telephone number listed on our web site?
(Y/N) _____________
Do you want your email address listed on our web site?
(Y/N) _____________
Spouse’s Name ____________________________
Did your spouse graduate from CHHS? _____ (Y/N)
If Yes, What year? __________
If No, What School & Year, ______________________________________________
Additional Info: ______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Mail to: CHHS Class of 1961
P.O. Box 851198
Yukon, OK 73085-1198
Download Printable Form (Here)
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