SOUTH SHORE ALUMNI REGISTRATION FORM

Since 1958, South Shore has provided many terrific summers (and school years) for staff and campers (students). As we look forward to our 50th Anniversary Celebration in 2008, we want to expand our existing database to be able to contact as many alumni possible.

Please Fill Out the Registration Form Below

First Name : Last Name :

Street Address :

City : State: Zip:

Email Address:

Contact Phone :

Camper /Student : Yes No

Years Attanded:

Staff: Yes No

Years Worked:

Position:

FRIENDS THAT YOU ARE INTERESTED IN GETTING IN TOUCH WITH:

1149 Newbridge Rd. North Bellmore, NY 11710 TEL: 516-785-3311 FAX: 516-785-3309
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