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| Your Class Year: |
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| Your First Name: |
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| Your Middle Name: |
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| Your Maiden Name, if applicable: |
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| Your Last Name: |
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| Gender: |
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| First year of attendance at UH - ACHS: |
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| Last year of attendance at UH - ACHS: |
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| Other schools attended and years: |
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| Did you graduate from UH - ACHS?: |
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| Your Phone Number(s): |
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| Your Email Address(es): |
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| Address 1: |
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| City: |
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| Next Family Member First Name: |
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| Relationship: |
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| Gender: |
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| First year of attendance at UH - ACHS: |
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| Last year of attendance at UH - ACHS: |
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| Other schools attended and years: |
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| Did he/she graduate from UH - ACHS?: |
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| Class Year: |
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| Living or Deceased (date if applicable): |
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| Phone Number(s): |
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| Email Address(es): |
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| Address 1: |
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| Address 2: |
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| City: |
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| Next Family Member First Name: |
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| Relationship: |
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| Gender: |
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| First year of attendance at UH - ACHS: |
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| Last year of attendance at UH - ACHS: |
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| Other Schools Attended and Years: |
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| Did he/she graduate from UH - ACHS?: |
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| His/Her Class Year: |
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| Living or Deceased (date if applicable): |
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| Phone Number(s): |
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| Email Address(es): |
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| Address 1: |
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| Address 2: |
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| Next Family Member First Name: |
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| Family Member Maiden Name, if applicable: |
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| Family Member Last Name: |
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| Relationship: |
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| Gender: |
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| First year of attendance at UH - ACHS: |
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| Last year of attendance at UH - ACHS: |
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| Other Schools Attended: |
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| Did he/she graduate from UH - ACHS?: |
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| His/Her Class Year: |
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| Living or Deceased (date if applicable): |
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| Phone Number(s): |
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| Email Address(es): |
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| Address 1: |
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| Address 2: |
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| State: |
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| Next Family Member First Name: |
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| Family Member Middle Name: |
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| Family Member Maiden Name, if applicable: |
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| Family Member Last Name: |
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| Relationship: |
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| Gender: |
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| First year of attendance at UH - ACHS: |
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| Last year of attendance at UH - ACHS: |
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| Other Schools Attended: |
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| Did He/She Graduate from UH - ACHS?: |
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| His/Her Class Year: |
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| Living or Deceased (date if applicable) |
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| Phone Number(s): |
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| Comments, memories, or additional Information: |
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| Date: |
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| I/we hereby grant permission for my/our names, school information, comments, memories, and photographs to be posted on the website(s), displayed in scrapbooks and photo albums at alumni luncheons, reunions, and school related functions, published, etc. I have the permission of my family members to provide their information, memories, and photographs. I grant permission to share my/my family's contact information with the Alumni Association Records Clerk, my/our class reunion committee(s) or class administrator(s) for reunion purposes. (Rest assured, your contact information will NOT be displayed without your permission). |
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