ALUMNI REGISTRATION FORM

1953 GRADUATING CLASS: JANUARY JUNE  
LAST NAME AS IT APPEARED IN THE YEARBOOK 
NEW NAME (IF ANY)
FIRST NAME
NICKNAME (IF ANY)

CURRENT MAILING ADDRESS:
STREET ADDRESS 
CITY                   
STATE                 
ZIP CODE            

PHONE NUMBER (xxx-xxx-xxxx)

EMAIL ADDRESS 

Please add me to your association directory.  I understand that as a member of the Franklin K. Lane Class of 1953 Alumni Association my contact information as shown above will be listed in its membership directory and shared with all other members listed in that directory.  I further understand that while a conscientious effort will be made to confine disbursement of this data to the Association members, neither the Association, nor ZAZZOOM.COM, nor any of their officers, staff members, or employees may be held liable for any unauthorized use of this data.