Class Survey

Please fill out the form below. It is a questionaire that will give us a lot of information about our class and what everyone is doing. 
Your info will be kept confidential
and we will use it to create some interesting (anonymous) content in our future memory book. 

Mahalo! 

First Name *

Last Name *

Maiden Name

Married /Comitted Relationship *

Yes

No

Do you have children? *

Yes

No

If you have children, how many? Select one 1 2 3 4 5+

Are you employed? * Select one Yes No Off & On Retired Semi-Retired

What is / was your job? *

Describe your job if you wish

School memories fond / bad? *

Pick an answer that best describes you * Select one I peaked in High School I have blossomed since High School I am the same as in High School

What elementary school did you go to? *

What town, city, camp did you live in while in High School? *

What is your birthday mm/dd/yy *

Where are/did you work? *

Private sector

City, State, Government

Armed Forces

Home & Family Management

How many career changes did you have * Select one 0 (Same career) 1 2 3+

Submit