Birth Announcement

Contact Information

First Name *

Last Name *

Telephone Number (if we have any questions) *

E-mail Address *

Hospital *

Parents *

Address *

Baby’s Full Name on Birth Certificate *

Baby Sex

Male

Female

Weight

Date of Birth *

Grandparents (Please include city and state)

Paternal Grandparents and town residing in

Great-Grandparents (Please include city and state)

Great-Great-Grandparents (Please include city and state)

We do not include a "deceased" or "late" grandparents or great-grandparents in our free announcement. If you wish to have this included it becomes a paid item. Fill in the information desired and a representative of the C-I Courier will contact you directly with the price. Thank you!

Parent(s) Signature *

*By signing this form, you consent to have your baby's birth announcement published in C-I Courier.

Date *

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Birth Announcement

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