Patterson School Reunion 2022 Registration Form

Patterson School Reunion 2022 Registration Form

Welcome Home!
REUNION DATES: August 5 - 6, 2022

TIME: 5:00PM Friday through Saturday Night

EVENT LOCATION: The Patterson School

4646 Patterson School Drive, Lenoir, NC 28645
Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Date of Birth

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current Profession
Preferred Name Tag
Graduation Year, or Years Attended
Emergency Contact Person

First NameLast Name
Emergency Contact Person Phone Number

Area CodePhone Number
Relationship
Are you going to bring guests? If yes, then please indicate below:*
Payment Details
prevnext( X )
Registration Fee - Alumnus$50.00

Registration Fee - Guest$15.00

Quantity

Friday Night in Wiese Hall $20.00

Saturday Night in Wiese Hall$20.00

Camping$ Free

Reunion T-Shirt$20.00

QuantityT-Shirt

Total $0.00
Payment Method
Please make checks payable to: Patterson School Foundation and mail to PSF - Alumni Association, PO Box 500, Patterson, NC 28661-0500
Questions, Comments, or Suggestions
Should be Empty: