ÿþ<html> <head> <meta http-equiv="Content-Type" content="text/html; charset=windows-1252"> <meta http-equiv="Content-Language" content="en-us"> <title>Home Page</title> <meta name="GENERATOR" content="Microsoft FrontPage 4.0"> <meta name="ProgId" content="FrontPage.Editor.Document"> </head> <body> <h1 align="center"><font color="#0000ff">WRHS</font> Student Questionnaire</h1> <form method= "post" action="http://www.globat.com/scripts/formemail.bml"> <input type="hidden" value="tedmitchell@prodigy.net" name="my_email"><input type="hidden" value="WRHS Alum Questionnaire" name="subject"><input type="hidden" value="tedmitchell@prodigy.net" name="from"><input type="hidden" value="http://washburnrural.com/misc/thank_you.htm" name="thankyou_url"> <input type="hidden" name="order" value="CLASS_OF, DATA_SHARED, MAIDEN_NAME, LASTNAME, FIRSTNAME, MIDINIT, AOL_IM_S_NAME, EMAIL_ADD, AREA_CODE, PHONE_NUMB, STREET_ADD1, STREET_ADD2, CITY, STATE, COUNTRY, ZIP_CODE, SIG_O_LNAME, SIG_O_FNAME, SIG_O_S_NAME, SIG_O_EMAIL, NO_OF_KIDS, NO_OF_G_KIDS, WHO_NOS_U_LN, WHO_NOS_U_FN, WHO_NOS_U_AD1, WHO_NOS_U_AD2, WHO_NOS_U_CITY, WHO_NOS_U_STATE, WHO_NOS_U_ZIP, WHO_NOS_U_AC, WHO_NOS_U_PHONE, WHO_NOS_U_SN, WHO_NOS_U_EMAIL, COMMENTS"> <h3 align="center">Alum, select class year, Teachers, select &quot;T&quot;, others select &quot;O&quot;<br> Class of:&nbsp; <select size="1" name="CLASS_OF"> <option>1917</option> <option>1918</option> <option>1919</option> <option>1920</option> <option>1921</option> <option>1922</option> <option>1923</option> <option>1924</option> <option>1925</option> <option>1926</option> <option>1927</option> <option>1928</option> <option>1929</option> <option>1930</option> <option>1931</option> <option>1932</option> <option>1933</option> <option>1934</option> <option>1935</option> <option>1936</option> <option>1937</option> <option>1938</option> <option>1939</option> <option>1940</option> <option>1941</option> <option>1942</option> <option>1943</option> <option>1944</option> <option>1945</option> <option>1946</option> <option>1947</option> <option>1948</option> <option>1949</option> <option>1950</option> <option>1951</option> <option>1952</option> <option>1953</option> <option>1954</option> <option>1955</option> <option>1956</option> <option>1957</option> <option>1958</option> <option>1959</option> <option>1960</option> <option>1961</option> <option>1962</option> <option>1963</option> <option selected>1964</option> <option>1965</option> <option>1966</option> <option>1967</option> <option>1968</option> <option>1969</option> <option>1970</option> <option>1971</option> <option>1972</option> <option>1973</option> <option>1974</option> <option>1975</option> <option>1976</option> <option>1977</option> <option>1978</option> <option>1979</option> <option>1980</option> <option>1981</option> <option>1982</option> <option>1983</option> <option>1984</option> <option>1985</option> <option>1986</option> <option>1987</option> <option>1988</option> <option>1989</option> <option>1990</option> <option>1991</option> <option>1992</option> <option>1993</option> <option>1994</option> <option>1995</option> <option>1996</option> <option>1997</option> <option>1998</option> <option>1999</option> <option>2000</option> <option>2001</option> <option>2002</option> <option>2003</option> <option>2004</option> <option>2005</option> <option>2006</option> <option>2007</option> <option>2008</option> <option>2009</option> <option>2010</option> <option>2011</option> <option>2012</option> <option>2013</option> <option>2014</option> <option>2015</option> <option>2016</option> <option>2017</option> <option>2018</option> <option>2019</option> <option>2020</option> <option>2021</option> <option>2022</option> <option>2023</option> <option>2024</option> <option>2025</option> <option>2026</option> <option>2027</option> <option>2028</option> <option>2029</option> <option>2030</option> <option>T</option> <option>O</option> </select></h3> <h3 align="center">May we include your data on the <font color="#0000ff">WRHS</font> website?&nbsp; <select size="1" name="DATA_SHARED"> <option value="Y" selected>Yes</option> <option value="N">No</option> </select></h3> <p align="center">&nbsp;</p> <blockquote> <h2 align="center"><font color="#008000">Use the tab key to move from field to field.</font></h2> </blockquote> <h3 align="center"><font color="#008080">Click Submit or press Enter when the questionnaire is complete.</font></h3> <h1 align="center"><font color="#ff0000">(Do not press Enter until the form is complete!)</font></h1> <p align="center">&nbsp;</p> <h2 align="center">About you:&nbsp;&nbsp;</h2> <h4 align="center">Last Name in High School: <input size="18" name="MAIDEN_NAME" uppercase text-transform:></h4> <h4 align="center">Current Last Name:&nbsp; <input size="18" name="LASTNAME">&nbsp;&nbsp;&nbsp;&nbsp; First Name:&nbsp; <input size="12" name="FIRSTNAME">&nbsp;&nbsp;&nbsp;&nbsp; Middle Initial&nbsp;&nbsp; <input size="1" name="MIDINIT"></h4> <h4 align="center"><br> Instant Message Screen Name:&nbsp; <input name="AOL_IM_S_NAME" size="20"><br> E-mail address:&nbsp; <input size="60" name="EMAIL_ADD"></h4> <p align="center">&nbsp;</p> <h4 align="center">Area code:&nbsp; <input size="3" name="AREA_CODE">&nbsp;&nbsp;&nbsp;&nbsp; Phone number:&nbsp;&nbsp; <input size="8" value="xxx-xxxx" name="PHONE_NUMB"></h4> <h4 align="center">Street address:&nbsp; <input size="50" name="STREET_ADD1"><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input size="50" name="STREET_ADD2"><br> City:&nbsp; <input name="CITY" size="20">&nbsp;&nbsp; State (or None if outside USA):&nbsp; <select size="1" name="STATE"> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NA">None (not in USA)</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="VI">Virgin Islands</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value=" " selected>Type first character then use the drop down list</option> </select>&nbsp;&nbsp;&nbsp;<br> Country:&nbsp; <input size="18" value="USA" name="COUNTRY">&nbsp;&nbsp; Zip Code:&nbsp; <input size="10" name="ZIP_CODE"></h4> <p align="center">&nbsp;</p> <h2 align="center">About your significant other:</h2> <h4 align="center">Last name:&nbsp; <input size="18" name="SIG_O_LNAME">&nbsp;&nbsp; First name:&nbsp; <input size="12" name="SIG_O_FNAME"></h4> <h4 align="center"><br> Instant Message Screen Name:&nbsp; <input name="SIG_O_S_NAME" size="20">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<br> E-mail address:&nbsp; <input size="60" name="SIG_O_EMAIL"></h4> <p align="center">&nbsp;</p> <h4 align="center">Number of children:&nbsp; <input size="2" value="0" name="NO_OF_KIDS">&nbsp;&nbsp; Number of grandchildren:&nbsp; <input size="2" value="0" name="NO_OF_G_KIDS"></h4> <p align="center">&nbsp;</p> <h3 align="center">Information about someone in the US who might always know how to contact you:</h3> <h4 align="center">Last name:&nbsp; <input size="18" name="WHO_NOS_U_LN"><br> First name:&nbsp; <input size="12" name="WHO_NOS_U_FN">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</h4> <h4 align="center"><br> Street address:&nbsp; <input size="50" name="WHO_NOS_U_AD1"><br> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <input size="50" name="WHO_NOS_U_AD2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</h4> <h4 align="center">City:&nbsp; <input name="WHO_NOS_U_CITY" size="20">&nbsp;&nbsp; State:&nbsp; &nbsp;&nbsp;<select size="1" name="WHO_NOS_U_STATE"> <option value="AL">Alabama</option> <option value="AK">Alaska</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="DC">District of Columbia</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="GU">Guam</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NA">None (not in USA)</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="PR">Puerto Rico</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="VI">Virgin Islands</option> <option value="WA">Washington</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> <option value=" " selected>Type first character then use the drop down list</option> </select> Their zip:&nbsp; <input size="10" name="WHO_NOS_U_ZIP"><br> Area code:&nbsp; <input size="3" name="WHO_NOS_U_AC">&nbsp;&nbsp;&nbsp;&nbsp; Phone number:&nbsp; <input size="8" value="xxx-xxxx" name="WHO_NOS_U_PHONE">&nbsp;&nbsp;</h4> <p align="center">&nbsp;</p> <h4 align="center">Instant Message screen name:&nbsp; <input name="WHO_NOS_U_SN" size="20">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;<br> E-mail address:&nbsp; <input size="60" name="WHO_NOS_U_EMAIL"></h4> <p align="center">&nbsp;</p> <h4 align="center"><font color="#000080">In 1800 characters (300 words), share with us, the significant events in your life:</font></h4> <h3 align="center"><font color="#ff0000">If you use apostrophes, DOUBLE them<br> (press the key twice so they look like this (''))</font><br> &nbsp; <textarea name="COMMENTS" rows="10" cols="60"></textarea></h3> <p align="center"><input type="submit" value="Submit"><input type="reset" value="Reset" name="B2"></p> </form> <p align="center">&nbsp;</p> </body> </html>