Submit Birthday If you are human, leave this field blank. Person's Name Type of celebration planned Time, date and place Born (date, place) Age on birthday Parents Married (date, spouse's name) Is spouse living? Yes No If no, date of spouse's death Children, their spouses and city/state where they reside Job, church and club affiliations Any additional interests Name and phone number of person filling out the form Date to run the birthday announcement Photo attachment Captcha * Submit
