First Name:
Maiden Name:
Last Name:
Street Address:
Street Address 2:
City:
State:
Zip:
Day Phone:
Night Phone:
Email 1:
Email 2:
Years Attended:
(e.g. 1974, 1981)
Grades Completed:
Are you a Nativity Graduate?:
Yes No
If yes, what year?:
Would you be interested in serving as a contact person for your class to help find missing class members?:
Yes No
Please provide information on fellow classmates if you know their whereabouts:
Please provide Biographical Information, List interesting facts about yourself, your job or profession, marital status, children, hobbies, areas of special skills or expertise, etc:
Please list the names of your former teachers and what grades/subjects they taught you:
Please offer any special memories about your years at Nativity:
Please offer any personal comments or suggestions:
Security Code: *