Class of 1990 Reunion
Registration Form

After printing this form, please fill in the following information
and return it along with payment to the following address;

Class of 1990
c/o Teresa R. Carter
P.O. Box 1723
Halifax, VA 24558

Name: ____________________________
Spouse or Guest Name: ____________________________
Telephone Number: ____________________________
Additional Information (Optional)
Occupation: ____________________________
Marital Status: ____________________________
Children: ____________________________
Email Address: ____________________________
Other: ____________________________