Mt. Vernon Register-News
September 17, 2008
Birth Announcement Form
Date:
* required
SUBMITTER'S INFORMATION
Name:
* required
Address:
* required
City:
* required
State:
* required
Zip Code:
* required
Telephone:
* required
E-Mail:
NEWBORN'S INFORMATION
Parents:
* required
City of Residence
* required
:
Telephone:
* required
Name of Newborn:
* required
Male
Female
Date of Birth:
* required
Place of Birth:
* required
Baby's Weight:
* required
Length:
* required
First Child?
Other Children (list names and ages)
Maternal Grandparents:
City of Residence:
Paternal Grandparents:
City of Residence:
Maternal Great Grandparents
:
City of Residence:
Paternal Great Grandparents:
City of Residence:
Additional Information:
