Birth Announcement

I acknowledge that the following information is correct and contains all the information I wish printed about the birth of my child. PLEASE NOTE: If the parents of the child are not married, an additional form must be signed by the father if his name is to be used in the announcement. If you have any questions, please contact the Lifestyles Editor for additional information.

Birth Announcement On-Line Form

Person Completing This Form:

Date: Telephone Number:

E-Mail Address:

Child's Name:

Date of Birth:

Time: Sex:

Place of Birth:

Weight: Length:

Parents' Names:

Parents' Address:

Maternal Grandparents (Mother's Side):

Paternal Grandparents (Father's Side):

Great Grandparents:

Child's Brothers and/or Sisters:

For Additional Information Contact:

The Ponca City News
Lifestyles Editor
P.O. Box 191
Ponca City, OK 74602-0191

Fax: (580) 765-7800

Phone: (580) 765-3311

Email: lifestyles@poncacitynews.com

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