SCHURR HIGH SCHOOL – CLASS OF ’73 & ’74 30-YEAR REUNION

 

Name in High School: _______________________Current Name__________________________

                                     Last, First                                                       Last, First

Spouse/Guest Name: __________________________ E-mail: ____________________________

 

Address: __________________________________________ Phone #(____)_____-__________

                 Street                                        City,        ST    Zip 

Interested in Golf Tournament? (Y/N) _________  Interested in Family Picnic? (Y/N) ____________

 

Who would you most like to reconnect with?: ___________________________________________

 

Would you like to donate a door prize? (Y/N) _______ Total enclosed: _______________________

 

Or credit card: Type: MC  /  VISA  /  AMEX  (circle one)  DO NOT E-MAIL THIS INFO!!!

 

THERE IS A $5.00 SERVICE FEE TO USE YOUR CHARGE CARD AND PAYMENT

MUST BE RECEIVED BEFORE 4/27/04. You will see “Olympic 4x4” on your statement.

 

Name on Credit Card:_______________________________________  Amount: ____________

 

CC #_____________________________________________   Expiration Date: ______/______

 

Mailing address of CC: __________________________________________________________

                                       Street                                          City,                                  ST   Zip 

 

Signature of CC Holder: _________________________________________________________

 

 

Costs: $75/Single $125/Couple ** $50/pp to Golf **  $10/pp Family Picnic

 

Send to:

Schurr ’74 Reunion

C/O Geri (Calderon) DeVille

1240 S. Lynwood St.

La Habra, CA 90631