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Madison Courier
Birth Form
The Madison Courier would love to help you announce the arrival of your new baby. Please fill out this form online and click submit at the bottom or download this form to your desktop. PRINT all information requested then email to zelda@madisoncourier.com, FAX us at (812) 273-6903 or mail it to: The Madison Courier, Attn: People, 310 Courier Square, Madison, IN 47250. If you have any trouble downloading this file please notify the webmaster@madisoncourier.com
Name of Person Submitting Form: * required
Daytime Phone: * required
Gender
Parent Names: * required
Hometown of Family: * required
Child's Full Name: * required
Child's Birth Weight: * required
Child's Birth Length: * required
Date of Birth: * required
Hospital and Location: * required
Maternal Grandparents and Hometowns:
Paternal Grandparents and Hometowns:
Names and Ages of Siblings:
Would You Like This Information Submitted to Vevay Newspapers?
Names of friends or relatives living in Vevay area.
Submit
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