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  If you would like to submit pictures for your CyberAnnual page (highly encouraged!),    and attach the picture(s) to the email.
Please fill in all fields marked with a *
Full name in 1969 *
Current Name if different
Street Address or PO Box *
City *
State *
Zip Code *
Email address *
Website URL
Spouses name if married
Info regarding children and grandchildren
Your occupation
Tell us about your life since 1969
Any message you would like to share with classmates
Your birthday
Would you like your birthday remembered on the website Yes
Would you like a free Messick 1969 personal email address Yes
If so provide username and password for email account
Would you like to receive occasional emails regarding major life events of classmates Yes
Would you like to receive a monthly email update of the Messick 1969 website Yes
May we post an encrypted link to your email so classmates can contact you Yes
Any special comments or instructions