Full Name:
 

Maiden Name:


E-Mail Address:
 

Alternate E-Mail:

Year of Graduation

 

Are you currently on our Alumni E-mail Listing?
No Yes

Street Address:
 


City:
 

State:
 

Zip:
 

Telephone

Home:    Work: Cell:

Do you have a personal or business website that you'd like us to list?

 

 

 

 

 

 If so, enter the URL:


If you entered your website above, what is the nature of your website?


Your Birthday (month and day only):


Your Occupation:


Spouse/Significant's Name:
Spouse Significant None


Spouse/Significant's Occupation:


Family Statistics
Children's Names and Ages:


Grandchildren's Names and Ages:



What high school incidents stand out most in your mind?


What have you been doing since graduating from Long Beach?


Future plans:


What faculty member(s) do you remember the best and why:

Any information you can give us on any missing people would be greatly appreciated, even if it is only a city, married name, place of employment, phone number or spouse's name. Please share with us any information you may have on any missing alumni. Will have an updated list after the 2003 reunion.

Any further Comments/Notes/News?


 

Note: We reserve the right to edit the information received on this questionnaire. We will utilize your name and most current address in any reunion booklet in the event you do not return the questionnaire.