Questionnaire Form

Please complete this questionnaire form below to update your information.  This way we will have your information for future reunions and communications.

If you prefer, you can click HERE to print the form to fill out, and send back by mail, email, or fax.

You have the option to make certain sections, or all of your information private.  Rest assured that your information is only being handled by one person on the committee and will be kept confidential if you mark it that way.

First Name *

Middle Name

Last Name *

Maiden Name

Nickname

Address 1 *

Address 2

City *

State/Prov. * Select one Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code *

Country Select one USA Canada United Kingdom Australia Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo (Brazzaville) Congo (Kinshasa) Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia Gabon Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar (Burma) Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Reunion Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Bahamas The Gambia Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu USA Uganda Ukraine United Arab Emirates Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wallis and Futuna Western Sahara Yemen Yugoslavia Zambia

Do you wish to keep your address private? * Select one Yes No

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Home Phone

Work Phone

Cell Phone

Do you wish to keep your phone numbers private? * Select one Yes No

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Email 1

Email 2

Personal Website

Do you wish to keep your email address private? * Select one Yes No

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Date of birth *

Occupation

Marital Information *

Single

Married

Engaged

Separated

Divorced

Widow/Widower

Spouse Name

If married, what is the date of your wedding anniversary?

Are you married to another Hale Ranger Grad?

Which Hale Grad are you married to?

In which year did your spouse graduate from Hale?

Children (names)

Grandchildren (names)

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Do you have ideas or comments for the 35 year reunion?

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Have you been in the military? * Select one Yes No

Military Branch

Retired from the military? Select one Yes No

When did you join the military?

How long did you serve in the military?

What was your title in the military?

Where was your basic training?

Where have you been stationed in your military career?

What kind of work did you do (or still currently do) in the military?

Any military decorations?

Did you serve with any other classmates, or know of any other classmates in the military?

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Do you wish to keep your entire record private? * Select one Yes No, only as indicated above

Submit