Fairley High School

Memphis, Tennessee

Class of 2004 10th Anniversary Reunion

June 20-22. 2014

REGISTRATION FORM
Last Name:____________________

First Name:______________________

Address:_____________________________

City:_________________________

State:________

Phone:__________________________

Zip:____________

MI:___

Email:_______________________________ @_____________________________

Reunion T-Shirts:
Small___ Medium____ Large_____ X-large____ 2X____ 3X_____4X______

Registration Fee

$30 each x ___= ____ (required)

Single Classmate

$125 each x___=_____

Classmate w/Spouse

$175 each x___=_____

Total: $____

Please mail completed form and check to:

Ashley Chamberlain
FHS C/O 2004 Reunion
7630 Brookwood Place
Southaven, Ms. 38671
Registration Due By: February 1, 2014 Checks payable to: FHS Class of 2004 Reunion
Contact Persons:
Ashley Chamberlain Cell: 901-483-9040

Brittney Williams Cell: 901-830-4706