Fairfield High School Class of 76
30 Year Class Reunion
June 24, 2006
YES, I (We) will attend the Reunion – Enclosed is a check for $______________
NO, I am unable to attend, but the following information is provided for the reunion files
YES, I will also attend the Classmates Night June 23 at Symmes Tavern
First Name: ________________
Last Name: ________________
Maiden Name: ________________
Mailing Address: ________________________________________
City: ________________
State: ________________
Zip Code: ________________
Phone Number: ____________________
e-mail address: ____________________
Spouse/Guest Name:
Children Names/Ages:
Grandchildren Names/Ages:
Return registration information and make checks payable to:
Mike Brill, 5540 Walther Drive, Fairfield, OH 45014