Family Name at School**:
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Family Name Now:
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Given Names:
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Given/Nickname at PMS**:
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Title Now:
Email Address:
Telephone Number:
Postal Address:
Year Attended PMS** Year 7:
Year Attended PMS** Year1 (8):
Year Attended PMS** Year2 (9):
Year Attended PMS** Year3 (10):
Year Attended PMS** Year4 (11):
Year Attended PMS** Year5 (12):
Years on Staff 1st Appointment:
Years on Staff 2nd Appointment:
Years on Staff 3rd Appointment:
Primary School(s):
Year and Place of Birth:
Secondary School (Other than PMS):
Suburb/Town of Family Home during time at PMS:
Entrance Qualification:
Full Scholarship
Entrance Scholarship
Soldiers Scholarship
Music Scholarship
Academic Scholarship
Dance Scholarship
Junior Certificate
Equivalent Junior
Other (give details below)
Other Entrance Qualification (If applicable):
Faction/House:
PMS Highlights:
Further Education** (uni, tech college,etc):
Current Occupation**:
Degrees or Other Qualifications**:
Occupation(s) on leaving School or after subsequent education:
Career Highlights**:
Lifetime Achievements:
Name of Person Providing This Information:
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Telephone Number:
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Email Address:
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Postal Address:
Relationship to Ex-Student:
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Other family members who attended Mod (show years):
Permission to Publish (for items marked with **):
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