AND THE SONG GOES ON

NAME:____________________________________________


ADDRESS:_________________________________________

HOME PHONE: (______)______________________________

BIRTHDAY:  (MONTH/DAY) ____________________________

DO YOU DRIVE? _______ COULD YOU CARPOOL? ________

WHAT ARE YOUR INTERESTS: (hobbies, occupation, special skills):

___________________________________________________

DO YOU READ MUSIC?    Yes     No

DO YOU PLAY AN INSTRUMENT? ________________________

IF A SEASONAL RESIDENT DATES HERE: _________________

AWAY ADDRESS: _____________________________________

AWAY PHONE #: (_______)_______________________________