| E-mail: |
|
|
|
| YOUR NAME FOR ORDER TRACKING: |
|
|
|
| Shipping address |
|
|
|
| Phone #: |
|
|
|
| Child's First Name: |
|
|
|
| Middle Name ( optional ): |
|
|
|
| Last Name: |
|
|
|
| Boy or Girl: |
|
|
|
| Age ( optional ): |
|
|
|
| Hometown: |
|
|
|
| State |
|
|
|
| Dedication : |
|
|
|
| Write in Dedication: Only if above NOT used |
|
|
|
| Book is from: |
|
|
|
| Three friends or relatives: |
|
|
|
| ADDITIONAL for My Baby Book ( optional): |
|
|
|
| Date of Birth: |
|
|
|
| Time of Birth: indicate AM or PM |
|
|
|
| Baby's Weight: pounds/ ounces |
|
|
|
| Baby's Length: |
|
|
|
| Delivered by: |
|
|
|
| Hospital: |
|
|
|
| Mom's First Name: |
|
|
|
| Dad's First Name: |
|
|
|
| Special Instructions: TYPE RUSH for 2-3 day delivery |
|
|
|
| Coupon Code: |
|
|
|
| |