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Print This Form for Mailing with Classmates Dues
___
Enclosed is
$
10.00
2012 Annual Dues: DHS Class of 1956 Alumni Association
___
Enclosed is $_____.__ Past Year’s Dues: ____ 2011____ 2010 ___2009 ___
2008 ___ 2007 ___ 2006
___
Enclosed is $_____.__ DHS Class of 1956 Memorial Fund Donation –
Total Sent: $_____.__ Date: ____|____|____ Check Number:
__________ Processed ___ (by office)
Please make payments payable to
Classmate’s Name:
___________________________________ Nickname:
_____________Maiden:________________
Mailing Address: _____________________________________Spouse or
Companion: _________________________
City:
__________________________________ State: ______ Zip / Mail Code:
____________ Country: _____________
Home Phone:
____________________________________ Cell Phone:
_______________________________________
Email Addresses:__________________________________________________________________________________
Please
Update: Years Married _____ D | W | S Children ___ Step Children ___ Grand
Children ___ GGC Children ____
Military Service ____________ Yrs ___ Occupation
_____________________________ (Retired Y | N)
Interests | Comments:
______________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
_________________________________________________________________________________________________
(Please write additional comments on back of this form)
The Treasurer then forwards the Classmates profile information to Webmaster
Skip Doyle .
And Memorial Fund
Donation if desired
2012 Annual Dues and Memorial Fund Donation
To check your Dues Status: contact
Treasurer
Ken McAfee
or Webmaster
Skip Doyle
The webmaster updates data into the DHS1956 Classmate Roster for you to refer to and
enjoy.
Please
Mail this Form with your Payment to:
DHS Class of 1956 Alumni Association
Kenneth McAfee, Treasurer
48
Hawthorne Court
Cumberland,
Maine
04021
Tel:
(207) 829-3251
Email:
juken21@myfairpoint.