YMCA CAMP PENDALOUAN
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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:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Maiden Name, if applicable:
Spouse's Name, if applicable:
Preferred E-Mail Address:
Preferred Snail Mail Address:
Home
....
Business
SOCIAL
MEDIA
Account?
Username or Public Profile?
Facebook:
Yes
No
https://www.facebook.com/
Twitter:
Yes
No
https://twitter.com/#!/
LinkedIn:
Yes
No
https://www.linkedin.com/
Instagram:
Yes
No
https://www.instagram.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...(!)