December 02, 2008 11:34 am — Order Fulfillment 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 City: Cardholder's State Cardholder's Zip: Phone # of Cardholder: Card Type: Choose One Visa MasterCard Discover American Express 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.
Attn: Celebrations writer 8109 Kingston Street, Suite 500 Avon, IN 46123
Photo emailed: Yes No To submit photos, send email to: Charlee Beasor or for questions phone (317) 272-5800 ext. 173
Copyright © 1999-2008 cnhi, inc.
