Saturday, May 25th, 2013

Items denoted with a red asterisk * are required.
 * Name
 

Include Maiden Name
 * Mailing Address
 
Address 1
Address 2
City
State
Zip Code

Mailing Address will not appear on Class Bio Page.
Phone Number
 
 -  - 
Phone Number will not appear on Class Bio Page.

(XXX)-XXX-XXXX
Cell Phone Number
 
 -  - 
Cell Phone Number will not appear on Class Bio Page.

(XXX)-XXX-XXXX
 * E-Mail Address
 

E-Mail Address will not appear on Class Bio Page.
Year Left Wellsville
 

If still in Wellsville, enter Still Here.
Do you still have family in Wellsville?
 
Employer
 
Employment Position
 
Years with Present Employer
 
Married
 
Month/Year Married
 
Spouse/Significant Other Name
 
Do you have any Children?
 
First Child's Name
 

Include year born
Second Child's Name
 

Include year born
Third Child's Name
 

Include year born
Fourth Child's Name
 

Include year born
Fifth Child's Name
 

Include year born
Sixth Child's Name
 

Include year born
College
 
Year Graduated College
 
College Degree
 
Served in Military?
 
Military Branch
 
Years in Military
 
Year left Military
 
Rank when discharged
 
Background of Spouse/Significant Other
 

Include Hometown, High School, College and other items of interest.
Background information on yourself or family
 
Anything other information you wish to add?