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Chesterton High School Alumni Association Inc.
Membership Form
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Membership
Lifetime Membership is $50
First Name
*
Your answer
Last Name
*
Your answer
Maiden Name
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Email
*
Your answer
Birthday
*
MM
/
DD
/
YYYY
Class of: (YYYY)
*
Your answer
Do you want to be listed in the Alumni Directory?
YES
NO
Spouse's Name
Your answer
Anniversary (if applicable)
MM
/
DD
/
YYYY
Is spouse a CHS Alumni?
YES
NO
If YES, Class of (YYYY)
Your answer
Are your children CHS Alumni?
YES
NO
If so, how many?
Your answer
Did you serve in the Military?
YES
NO
If so, which Branch?
Your answer
College Attended
Your answer
Career
Your answer
Are you a CHS Faculty member?
YES
NO
When? From - To (YYYY)
Your answer
Which CHS Facility/Facilities?
Your answer
THANK YOU!
Thank you for completing your CHS Alumni Association application. Please use this
secure link
to pay your membership online.
-OR-
mail your membership check or money order payable to CHS Alumni Association, PO BOX 1063, Chesterton, IN 46304.
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