PEABODY HIGH SCHOOL ALUMNI ASSOCIATION 

2010 ANNUAL MEETING REGISTRATION FORM

Saturday, June 12, 2010

For printable version click here
adobe acrobat needed

PHS Class of __________

Name: ____________________________________________________________
            First                              M.I. or Maiden(VERY IMPORTANT)            Last

Address: ___________________________________________________________

               ___________________________________________________________

E-Mail:  _____________________________________ Date of Birth________________

PHSAA DUES                                                                            $10.00 

SCHOLARSHIP CONTRIBUTION(S):

            General Fund                                    ___________

            Designated Fund(s) please specify below:
                        Paul Dennison                         __________
                        E.C. Barker                             __________
                        A.F. Bridges                           __________
                        Lucille Ayers                           __________
                        Walter Kilzer                           __________
                        Class of 1963                          __________
                        Andy/Theresa Jonas                __________
                        Anne B. Love                         __________
                        Bill Jones Jr.                            __________
                        Andy Stott                              __________
                        Adam Hickerson                     __________
                        Dr. Larry Williams                  __________
                        Michael Harper                       __________
                        Judy Nunley                            __________
                        Aredus Buck Wade Jr.            __________
                        Matt Morris                             __________
                        Erika Kirk                               __________
                        Andy Yarbrough                     __________
                        Bettye Joyce Brown Green     __________

                                   
            Scholarships Subtotal                                                ___________
         
            TOTAL ENCLOSED                                               ___________

I DO _____ DO NOT____ PLAN TO EAT LUNCH IN THE COMMONS AREA

Please print the registration form and

mail it along with your enclosed check to:

Peabody High School Alumni Association

PO Box 33, Trenton, TN  38382

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