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Wednesday

April 2014

23

Birth Submission Form

Let us know about the new arrival in your family for free publication in the newspaper of your choice.

1.Enter information about your immediate family here:
Mother's Name*
Father's Name*
Town of Residence*
Baby's Name*
Baby's Sex*
Date of Birth*
Time of Birth*
Weight/Length*
Hospital
Siblings
2.Enter information about extended family here:
Maternal Grandparents' Names
Maternal Grandparents' Town of Residence
Paternal Grandparents' Names
Paternal Grandparents' Town of Residence
Maternal Great-grandparents
Maternal Great-grandparents' Town of Residence
Paternal Great-grandparents
Paternal Great-randparents' Town of Residence
3.Contact Information
Name of Person Submitting Request*
Phone Number*
E-mail*
4.Comments or notes
5.In which paper(s) would you like your birth announcement published?*
Lake Country Reporter
Oconomowoc Focus
Sussex Sun
Kettle Moraine Index
Mukwonago Chief
Waukesha Now

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