WHS '71 Directory Registration Form

Thank you for having interest in the Wheaton High School class of 1971 Directory! Please take a moment to fill in the following information. It will be used to maintain a database so that we can contact you about future events. We realize that we may already have some of this information from you but we request that you complete this form so that we have all of the information needed to stay in touch.

WHS71 Classmate Information

First Name * Last Name *

Nickname Maiden Name

Contact Information

Address * Email Address *

City * Primary Phone *

State * Secondary Phone

Zip Code * Facebook Name

Consent * Note: We will Not Include Your Contact Information in the on-line directory unless you answer "OK" to this question

Comments, Questions, or Suggestions

PRESS SUBMIT
ONE TIME ONLY!
Takes a minute or
two to complete

After you submit, you will be returned to the home screen.
All Fields marked with an asterisk are required to be filled in.

Web Page courtesy of Jeff Grover (c) 2016

WHS '71 Directory Registration Form
Thank you for having interest in the Wheaton High School class of 1971 Directory! Please take a moment to fill in the following information. It will be used to maintain a database so that we can contact you about future events. We realize that we may already have some of this information from you but we request that you complete this form so that we have all of the information needed to stay in touch.

WHS71 Classmate Information
First Name *		Last Name *
Nickname		Maiden Name

Contact Information
Address *		Email Address *
City *		Primary Phone *
State *		Secondary Phone
Zip Code *		Facebook Name


Consent *		Note: We will Not Include Your Contact Information in the on-line directory unless you answer "OK" to this question

Comments, Questions, or Suggestions
PRESS SUBMIT ONE TIME ONLY! Takes a minute or two to complete
	After you submit, you will be returned to the home screen. All Fields marked with an asterisk are required to be filled in.

Web Page courtesy of Jeff Grover (c) 2016