Please fill in the registration form and mail it with your check, payable to Harding Class of '63, to:

NAME ____________________________ SPOUSE’S NAME ________________

HOME
ADDRESS ________________________________________________________

CITY _______________________________ STATE _____ ZIP ___________

TELE: HOME _____________ CELL ___________ BUSINESS _____________

BUSINESS
ADDRESS ________________________________________________________

CITY _______________________________ STATE _____ ZIP ___________

E-MAIL ADDRESS _________________________________________________