Bellevue West Class of 1987 Reunion Registration Form

If you and your spouse are both alumni of the class, please fill out separate reservation forms. Reservation Deadline: June 20, 2007
(Call (402) 291-5504 or email lori_ballinger@hotmail.com if you can't make the deadline.)

Send to: Bellevue West '87, 2505 Sheridan Road, Bellevue Nebraska 68123
Make check payable to: Bellevue West 1987

Name: ______________________________________
Maiden Name: ________________________________
Home Address: ____________________________________________________________________
________________________________________________________________________________
Home Phone: ____________________________
Work Phone: ____________________________
E-Mail Address: ___________________________________________________________________

The following information is optional and will assist us in locating you for your next reunion.

Drivers Lic. #: ___________________ State: ______ Birth Date: ________________
Parent's Names: ______________________________________________________
Permanent Address: ___________________________________________________
___________________________________________________________________

Reservations
Number attending: _______ x $50.00 Full Payment _______________ $ _________
      Or        _______ x $25.00 Partial Payment _______________$_________
                  _______ x $80.00 Couple       __________________ $_________
                  _______ x $35.00 Saturday Only ________________$_________
                  _______ x $15.00 Friday Only  _________________ $_________

Class 8 x 10 Photograph
Unique class photograph, which includes photo identification line-up list. Will be mailed to your home in 4-6 weeks after the reunion.
      Copies ________ x $15.00 = $ _________

Memory Book
***Do Not order a Memory Book if you are attending the reunion. A collection of addresses, memories of high school and biographical information on your classmates. Includes shipping and handling. Will be mailed to you following the reunion.
      Copies ________ x $10.00 = $ _________

Advertise your business in the Bellevue West Class of '87 Memory Book     
        ($10.00) = $ _________ Must send copy with payment

Total Enclosed ------------------------------------------------------------------ $_____________

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