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Make
check or money order payable to: |
Boy________Girl__________
First Name_________________________________Middle
________________________
Last
Name__________________________________Nickname____________________
Hometown________________________________________State__________________
Date of
Birth____________________________Time of
Birth_____________________
Length (Inches)__________________Weight (Lbs -
Oz)________________________
Doctor
___________________________Hospital________________________________
Mothers Name_________________________ Fathers
Name_____________________
| ________Adopted | ________Single Parent |
| ________Christian | ________Twins |
Dedication: (With Love From, Kisses From, etc.)_____________________________________________________
This book is from: (Mommy & Daddy, Nana Ruell, Auntie Lisa, etc.)_____________________________________
Gift date to be printed in book: _________________________________
Customer Information: Name_______________________________ |
Shipping Information - If Different Name_______________________________ |
If we have a
question: E-mail or Telephone: ___________________________
We will not call unless we
have a question on your order...we will not sell your address.
$14.00 Per Book |
$3.00 Shipping First Book |
Number of books_______________ |
