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: