First Name: ______________________ Last Name: ____________________ M.I.: _____

Maiden Name: ______________________ email address: __________________________

_____ Check if you don't want your email address available to other CHS '92 grads.

Street Address: _____________________________________________________________

City/State/Zip: ______________________________________________________________

Phone Number: Work _________________________ Home _________________________

Number of people attending: _____________ ($30 per person)

Guest Name(s)

(Attach additional sheets as needed.)

1. __________________________________________________________________________

2. __________________________________________________________________________

3. __________________________________________________________________________

4. __________________________________________________________________________

Amount enclosed: $_____________

(Please make your check payable to: Chatsworth High '92 Reunion)