First Name

Last Name            Maiden Name (if applicable)

Street Address 1

Street Address 2

City            State        Zip Code

Home Phone          E-mail Address

8th Grade Class of (please use 4-digit year)

Nickname (s) while attending St. Francis deSales

High School graduated from(School name, City & State, Year of Graduation)

College graduated from(School name, City & State, Year of Graduation)

Got new job?? Get married?? Working on a degree??
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