Registration 1956

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NOTE:  Please print out and mail today!

REGISTRATION

Send your completed reservation form and money

to

Vivian Corbin Theel

1913 Pineknoll Lane

Albany, GA 31707-3756


Your name
(please print full name including maiden and nickname)

______________________________________________________________

Spouse name____________________________________________________

Address_______________________________________________________

City___________________________State_______Zip+4________________

Phone_______________

E-mail address___________________________________________________

Friend/guest(s) attending reunion______________________________________

_______________________________________________________________

** If you are only attending one night, please indicate Fri. (  ) or Sat. (  )