Make check payable to:  Baker High School Class of 1964 Reunion

  Mail check and this completed form to:  Brenda VanLandingham Miller
         1227 Rosewood Ave, Columbus, GA 31907

Your name as you want it on your badge:  ___________________________________________

Your name while at Baker:                        __________________________________________

Your class year:                                      __________________________________________

What years were you at Baker:                 ___________________________________________

Guest’s name for badge:                          ___________________________________________

Did guest attend Baker?           No ___        Yes ___   Class year: ________
 
Number of registrations:                          _____ at $40.00  =   ____________

May we list you in “I’ll be there”?  Yes ___      No ___

Mailing address:             ____________________________________________

       ____________________________________________
 
      ____________________________________________
 
Phone:                                                  Day: _________________   Eve: _________________

Email address:      ____________________________________________
 
Where are you staying:                           ____________________________________________

Arrival Date:     ____________________________________________

Will you bring a Door Prize?  Yes ___ No ___

Interested in Golf on Sat?  No ___  Yes ___ - Handicap: ___________________

Dietary restrictions?   No ___  Yes ___ - Describe: ___________________

      ____________________________________________

Other comments:   ____________________________________________

      ____________________________________________