BHS ALUMNI REUNION

SATURDAY, MAY 19, 2012

BURGAW MIDDLE SCHOOL GYM
BURGAW, N.C.
NAME____________________________________________________________

CLASS YEAR______________________MAIDEN NAME________________

SPOUSE___________________________Class Year______________________

MAILING ADDRESS______________________________________________
_________________________________________________________________
PHONE #________________EMAIL ADDRESS

Early Registration Postmarked by April 1, 2012

Registration Per Person

$25.00

X number =

Total

Late Registration Postmarked after April 1,2012

Registration per Person

$35.00

X number =

Total

Total Amount Enclosed

Please make checks payable to: BHS Alumni Reunion
Mail to: Carol Jordan, 5415 Tralee Place, Raleigh, NC 27609
Email address: bhsalumnireunion@gmail.com
DUE TO BEING ON SCHOOL PROPERTY, NO SMOKING OR ALCOHOL WILL BE PERMITTED
SPONSORSHIP INFORMATION WILL BE SENT SOON.