CHS Class of 1973 50th Reunion Registration – Services for Success, Inc.

First Name

Last Name (including maiden name, if applicable)

Email

Spouse/Significant Other’s Name (if applicable)

Address

Street Address

Suite/Apt/Unit #

City

State/Province

Zip/Postal

Mobile phone

Birthdate

Names/Ages of Children/Grandchildren (if any)

Tell us about your parents/siblings and where they live, etc.

My Favorite Teacher(s) and/or Memory from CHS

Brief history since graduation (or since last reunion)

I will attend the Friday night gathering at Dann Schroeder’s home.

Yes

No

# attending Friday night

I will attend the parade and ride on the float on Saturday morning.

Yes

No

I will attend the reunion dinner on Saturday evening at Clarmond Country Club.

Yes

No

# attending Saturday night

I will submit my payment for my registration ($30/person) via:

Venmo @LuAnn-Freund

Credit card – MC/Visa/AMEX or e-check (If selected you will receive an email with a link to pay.)

Mail a check payable to “Class of 1973” to: 809 NE Lakeview Drive, Grimes, IA 50111

Suggestions for next reunion (when/where/committee members, etc.)