The Central High School Foundation & Alumni Association - ALUMNI INFORMATION
Please complete as much information as possible.
We DESPERATELY need this information for future purposes and will also be needed by your future Reunion Groups.
We appreciate your input and can guarantee that this information will only be used and maintained by The Central High School Foundation and Alumni Association.
KEEP US POSTED ON YOUR WHEREABOUTS! THANKS SO MUCH!
This form may also be downloaded, printed, and mailed.
Click Here
to download the form in Microsoft Word format.
Last Name
First Name
M.I./Name
Class Year
If Married, Maiden Name
Gender:
M
F
Nickname / Known in School As
Address
City
State
Zip
Country
Home Phone (with AC)
Home Fax #
E-mail Address
Birthdate: M/D/Y
Birthplace: City/State/Country
Social Security # (optional)
Race
Religion (optional)
Date Entered Central (Mo/Yr)
Date Graduated/ Left Central (Mo/Yr)
Grade Point Average at High School Graduation:
Where did you attend Elementary School?
Name
City
State
Where did you attend Junior High/Middle School?
Name
City
State
If Married, Spouse’s Information:
Last Name (if different)
First Name
M.I./Name
Spouse's Maiden Name
Gender:
M
F
Spouse's Date of Birth
If Deceased, Date
Spouse's Education:
Name of High School
Year Graduated
City
State
Information About Your Children (if applicable):
Last Name
First Name
Middle Name
Gender
1.
M
F
2.
M
F
Parent Information
(please list both parents and address information if different than yours)
Father’s /Guardian Name
Address
Home Phone #
City
State
Zip
CHS Grad? Year
Mother’s /Guardian Name
Address
Home Phone #
City
State
Zip
CHS Grad? Year
Other Family Members who are Central Graduates (Please include MAIDEN name):
Name
Relationship
Address
Home Phone #
City
State
Zip
Year Graduated
Name
Relationship
Address
Home Phone #
City
State
Zip
Year Graduated
Name
Relationship
Address
Home Phone #
City
State
Zip
Year Graduated
Name
Relationship
Address
Home Phone #
City
State
Zip
Year Graduated
Name
Relationship
Address
Home Phone #
City
State
Zip
Year Graduated
Please indicate the ACTIVITES YOU WERE INVOLVED IN DURING YOUR YEARS AT CENTRAL HIGH:
Academic Teams:
Athletics / Sports:
Clubs:
Honors / Awards:
Journalism:
Music – Instrumental:
Music – Vocal:
Performing & Fine Arts:
Senior Class Officer:
Student Government:
OTHER ACTIVITIES:
