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New Paltz Beckons - The legend demands that you return! - page 14 / 16

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Registrant InformationRegister online at: www.newpaltz.edu/alumni/reunionweekend 2010

We publish the names of registered attendees to the Reunion web site so your classmates can see who is coming to the celebration. If you do not wish to have your name added to this listing, please check here.

____________________________________________________________________

City

State

Zip Code

____________________________________________________________________

Work Phone

Fax Number

E-mail Address

WOULD YOU LIKE TO HELP US FIND LOST ALUMNI?

  • Yes - please contact me to provide more information

  • No

SPOUSE/GUEST INFORMATION

____________________________________________________________________

New Paltz Alum?

Yes

No

If YES, Class Year(s), Major(s) and Degree(s)

_____________________________________________________________________

Last Name

First

Maiden/Former (if applicable)

____________________________________________________________________

New Paltz Current/Former Faculty/Staff Member?

If YES, list department

Yes

No

_____________________________________________________________________

Employer

Job Title

_____________________________________________________________________

____________________________________________________________________

Last Name

First

Maiden/Former (if applicable)

New Paltz Alum?

Yes

No

If YES, Class Year and Major

____________________________________________________________________ Address

_____________________________________________________________________ Address

_____________________________________________________________________

____________________________________________________________________

City

State

Zip Code

City

State

Zip Code

____________________________________________________________________

Home Phone

Fax Number

E-mail Address

NAME TAG: NAME PREFERENCE ____________________________________________________________________ Class Member

____________________________________________________________________

Employer

Job Title

____________________________________________________________________ Spouse/Guest

____________________________________________________________________ Work Address

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