Memory Book Questionnaire

Please return the questionnaire promptly by submitting the form here, or mail it to Amy Johnson at P.O. Box 424, Gates Mills, OH 44040

Full Name (please include former name if any):
Email:
Address:
Phone:
Spouse:
Number of children: Grandchildren:
If spouse is a Shaker graduate, name and class:
Present job:
Spouse's job:

Tell us about you

Briefly tell a fond memory of Shaker:

Have you ever held public office? If so, what?
How did you vote in the last election?
How many states and countries have you lived in? Where?
When you retire, what would you like to do?
Where would you like to retire?
Hobbies, interests?
What elementary school did you attend?
Do you plan to attend the reunion on October 16–18?