Form Center

2. Which of the following situations fits you best?*

   1. I am so excited to see so many pinwheels, please add one to my family member
   2. I appreciate the DHS pinwheel project, but my family member would be best remembered with one. Please remove my student from your list:
   3. I love seeing so many DHS pinwheels in the cemetery. How can I be a part of this great project?

   For the first two options please fill out both Section A and Section B. For the third option please fill out Section B only.

4. Section A
6. Student's Full Given Name
8. Student's Birth Date
   Student's Birth Date
9. Student's Death Date
   Student's Death Date
10. Student's Graduation Year
12. Section B
14. What is your Full Name?*
16. What is your Phone Number?*
17. What is your email address?*
Leave This Blank:


19. 1. Receive an email copy of this form.
20. Email address

    This field is not part of the form submission.

21. Submit

* indicates a required field