Lebanon Reporter

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August 2, 2006

Birth Announcement Form

To ensure that a complete announcement of your child's birth appears in an upcoming edition of The Lebanon Reporter, please complete and submit this form. A quality photo of your newborn may be submitted in a separate e-mail. See instructions below. Birth announcements run in our Saturday edition. The submission deadline is the previous Thursday.

Parental Information:

MOTHER

Full Name: *required field

Mother's Maiden Name:*required field

FATHER

Full Name: * required field

Couples Daytime Phone:

*required field



Couples Address: *required field







BABY'S INFORMATION:



Full Name: *required field

Sex:*required field Male Female

Date of Birth: *required field

Place of Birth:*required field

Length:*required field Weight: *required field
Brother(s) : Name and Ages

Sister(s): Name and Ages

Maternal Grandparents:

(include town and state of residency)

Paternal Grandparents:

(include town and state of residency)

Maternal Great-Grandparents:

(include town and state of residency)

Paternal Great-Grandparents:

(include town and state of residency)

Other Interesting Facts:

Information Submitted By: *required field

(name, relationship, phone number)

PHOTO:

Photo submitted: Yes No

I will email photo.

I will drop off photo at The Lebanon Reporter.

To submit photos, send email to: news@reporter.net

Identify the subjects in the photograph in the Subject line of the email.

How many copies of the paper would you like?

(reserved papers must be paid for and picked up at The Lebanon Reporter office within 10 days)




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