Please Complete the Following:

NAME &
CONTACT
INFO
First Name Middle Name Last Name Jr, III, etc? PhD, MD, etc?
Name:
A Camp Nickname You'd Be Willing to Share?!
Birthdate:
Maiden Name, if applicable:
Spouse's Name, if applicable:
Preferred E-Mail Address:
Preferred Snail Mail Address: Home .... Business
SOCIAL
MEDIA
Participant?                 Username or Public Profile?
Facebook: Yes   No         http://www.facebook.com/
Twitter: Yes   No         http://twitter.com/#!/
LinkedIn: Yes   No         http://www.linkedin.com/
SCHOOL
HISTORY
School Name City State Class of.... Degree?
High School:
College/Univ:
Grad School:
HOME
INFO
Street Apt, Floor, Suite, PO Box
Mailing Address:
City State/Province - Zip/Postal Code Country, if not USA
CURRENT
SCHOOL
or
BUSINESS
INFO
Name of School or Business Your Title or Occupation
Street Apt, Floor, Suite, PO Box
Mailing Address:
City State/Province - Zip/Postal Code Country, if not USA
PHONE
NUMBERS
Home Phone No. Prim Schl/Bus Phone Addl Schl/Bus Phone Fax Phone Number Cell Phone No.
CAMP
ASSOCIATIONS
Please be as specific as possible describing your association(s) with YMCA Camp Pendalouan; i.e., '1982 to 1984 - Ranch Camp Director', 'Fall 1992 - Outdoor Ed Intern', '1991 - Memorial Weekend Family Camper', etc.. We'll confirm your descriptions with known records (rosters, payroll, newsletters, etc.). If you are unsure of exact years, include question marks - we'll work with you to make sure the information as is historically accurate as possible.
Season(s), Year(s) Description
RELATIVES
So, did that great-grandfather of yours attend camp as well? Your spouse? Your third cousin once-removed? We'd greatly enjoy learning about the history of your family members who have been involved with YMCA Camp Pendalouan through the generations.
First Name Last Name Relation ('he/she is my ...')
OTHER
COMMENTS?
Comments, questions, suggestions, stories? Please feel free to add your two cents worth...(!)