Class of 2017 Student Directory Form

Please complete this form if you would like your contact information included in the Senior Directory for the Class of 2017.
Student First Name
Your answer
Student Last Name
Your answer
Student Cell Phone Number
Your answer
Student E-mail Address
Your answer
Parent/Guardian First Name(s)
Your answer
Parent/Guardian Last Name(s)
Your answer
Family E-mail Address
Your answer
Permanent Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Foundation Release: Select "yes" or "no" to the following statement: I authorize the Bearden High School Foundation to contact me.
Please provide a phone number for the foundation to contact you with questions about the information provided. *This number will not be included in the directory.
Your answer
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