Clearfield High School
Class of 1969,  40th Reunion Info -

Name:  ______________________________________________________________

Spouse's Name:   ______________________________________________________

Occupation:  __________________________________________________________

Address:  _________________________________  City:  ______________________

State: ___________________  Zip Code:  _____________________________

Phone: _______ - ______ - __________  E-Mail: ______________________________

# of Children: _________________  # of Grandchildren: _______________

I / We Will : _____________ , Will Not :__________ Attend.

     # Reservations for Friday  Evening at $ 5.00 Each x  _____   =    $ ______________

# Reservations for Saturday Evening at $ 25.00 Each x _____  =     $ ______________

Donation to help Reunion Costs :                                                          $ ______________

Grand Total :                                                                                            $ ______________


Please fill out this information for our reunion booklet, and if you know of any classmate that we may have missed please let us know.

Mail this completed form to:
Patti Semelsberger
625 Elm Avenue
Clearfield, PA 16830

(814) 765-4032 , pattigsem@hotmail.com                                                                   BACK