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Sat, Nov 21 2009 

Published: June 11, 2009 10:27 am    print this story  

Birth Announcement Form



Order Fulfillment
 

HENDRICKS COUNTY FLYER TEXTsm.gif (5638 bytes)
Attn: Celebrations writer
8109 Kingston Street, Suite 500
Avon, IN 46123



 

Baby's Name: *required field 
 		 Male or Female? * required field 
 
Birth Date: * required field Time of Birth: * required field
  
Weight:* required field
 		 Height: * required field
  
Hospital:
 		 Siblings (ages and names):
Parents: (names and city of residence):* required field
 		 Grandparents: (names and city of residence)

Photo emailed: Yes   No
To submit photos, send email to: Charlee Beasor or for questions phone (317) 272-5800 ext. 173
PAYMENT INFORMATION:
Name as it appears on Credit Card:  
Cardholder's Address:  
Cardholder's City:  
Cardholder's State  
Cardholder's Zip:  
Phone # of Cardholder:  
Card Type:  
Card Number:  
Expiration Date:  

3-Digit Security Code:
 
Please enter the 3-digit security code found on the back of your credit card within the signature field.
Total Amount: $
I have read the above and understand this announcement will be edited to the Flyer's style. I also understand the Flyer is not responsible for lost or damaged photos.


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8109 Kingston St., Suite 500; Avon, IN 46123
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