2016 Reunion Registration Form

Mini Reunion
September 17, 2016
5:30 - 10:30 PM

Holiday Inn - Ontario Airport
2155 E. Convention Center Way
Ontario, CA 91764

Name at Graduation:

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Current Name:

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Mailing Address:

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City, State, Zip:

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Phone (our records only):

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Email Address:

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Any Additional Information:

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$25.00 per person

Number Attending

Total Enclosed

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Please Make Checks Payable to Upland Class of 1964
Mail Reservation and Check by August 1, 2016
to

UHS Class of 1964
C/O Marsha LaDam
1714 Desert Almond Way
Beaumont, CA 92223

951-212-1477

Help us locate missing classmates!
If you know of Classmates we are not in contact with,
please provide their names and addresses below:

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