CHS CLASS OF 1959
2009 REGISTRATION FORM

Please return this form by January 15, 2009.  
(Please print)

Name _____________________________________________________________________________________
       	(Last)			(First)			(Middle)			(Maiden)


Home Address ______________________________________________________________________________
		(Street)						(City) 		(State)		(Zip)

Home Telephone Number _(          )_______________________  

Cell Phone Number   (        )________________________                                                                                      

E-mail Address __________________________________

In case we lose you, please give us the name, address and telephone number of someone who will know how to contact you:
__________________________________________________________________________________________

Fees:		I will be attending:  ($50.00)…………………………..…….…$_____________________         

		I will bring my spouse or guest:  ($50.00)……………………$_____________________

		Name of spouse/guest_____________________________  (Please indicate which)

        I would like an extra copy of the Tom Tom:  ($15.00)………$_____________________	

		I cannot attend but I would like a copy of the Tom Tom
		mailed to me:  ($20.00)……………………………………...	…$_____________________

		I would like to purchase yearbook advertising (or personal
                          message) Must be formatted and camera ready:  											           Business card ($20.00)…….$_____________________

                                                                            ¼  page ($25.00)  ……….…$_____________________
					           
           ½  page ($50.00)  ………….$_____________________     
			     		          
 					           full page ($100.00)…………$_____________________

		I would like to make a contribution:……………………………$_____________________
		     (Any amount will be appreciated!)
							TOTAL: ………….$_____________________

Please mark one:   Check is enclosed_______     I will send my check by March 15th _______

Please make your check payable to:  Tulsa Central Class of 1959 and mail it with this form to
	
        Mrs. Maggie (Margaret Will) Cornell
	2926 East 75th Court
	Tulsa, OK 74136-5640

Questions?  Contact Karen Anderson Hughes at karenahughes@cox.net or (918) 627-4086 or (918) 636-8150