Shelbyville Daily Union

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January 18, 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:

 

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