First Name:

Last Name:

Street Address:

City:

State:

Zip Code

Home Phone

Cell Phone

Email Address:

Class of (year):

Acitivites / Clubs that you participated in while attending Cathedral:

Sports that you participated in while at Cathedral and # of years played:

Are you currently enrolled in college?

• Yes

• No

Are you currently employed?

• Yes

• No

If called upon, I would be interested in providing leadership or participating in:

• Planning my class reunion

• Homecoming Alumni Events

• Fundraising

• Other activities

Marital Status:

Choose... Single Married

Children (please list names & ages):

Comments/Questions:

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