IF YOU ARE UNABLE TO ATTEND, PLEASE USE THIS FORM
TO SUBMIT YOUR INFORMATION FOR THE MEMORY BOOK
AND/OR TO ORDER A MEMORY BOOK
When you submit, the page, if it reopens you left a required field blank.
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Student's Full Name *
Maiden Name
Street address *
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Zip Code *
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Please tell us about yourself / your family for our Memory Book!
Do you want to order a student directory/memory book? Yes No
Will you be using PayPal or Mailing a Check (Enter None, PayPal or Check) *
Mail check in the amount of $12.50 by June 15, 2016 to
EPCHS Class of 1971
% Pat Smith Edwards
14458 Nottingham Way Circle
Orlando, FL 32828
EAST PEORIA CLASS OF '71
Last Updated June 5, 2016
