201 4CHS-MHS  CLASS REUNION 

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TABLE REGISTRATION                                                                  NOTE: TABLE WILL NOT BE ASSIGNED UNTIL ALL 10 ATTENDEES ARE REGISTERED

                                                                                                           Date Received by Committee:                                                                                               

Date Submitted by Requester:                                                                                                                                                                                                        

Requester's Name:                                                                                                                                                                                                                              

Address:                                                                                                                                                                                                                                                  

Home Phone:                                                                      Cell Phone:                                                                                                                                             

I request the following registered attendees be assigned to this table (10 minimum).                                                                                                      

                            Name                                                                            Registered (Date)                                            CHS-MHS Class of:                               

1.                                                                                                                                                                                                                                                              

2.                                                                                                                                                                                                                                                              

3.                                                                                                                                                                                                                                                              

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7.                                                                                                                                                                                                                                                              

8.                                                                                                                                                                                                                                                              

9.                                                                                                                                                                                                                                                              

10.