Ordering - Step 3

We now need your remaining information to complete your order.

Please fill out this form in its entirety and click the continue button.

We do not manually edit your information provided. Information will be used exactly as typed, word-for-word, character-for-character. So, please take your time.

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Section 1 - Order Contact Info
First name:
Last name:
Street address:
Apt./Suite:
City:
State:
Zip code:
Phone:
E-mail:
Your relationship to child:	(e.g. Father)
How did you hear about us?	Select Retail Outlet Friend/Family Doctor/Hospital Advertisement Search Engine Display Newsgroup Other
Agent/Promo code:	(please enter a code if you have one to receive your free gift – A Child ID & DNA Kit)
Referral name:	(if you don’t have a code and were referred by someone)
What suggestions do you have to improve the product?
What other products or services would you like to have available through us?
If you are redeming a gift certificate please enter your gift certificate number here:
Section 2 - All About Baby
Birthdate:	Month: Day: Year: (e.g. 2002)
Baby's first name:
Baby's middle name:
Baby's last name:
Birth time:	am pm (e.g. – 12:53)
Height:	inches (e.g. – 15.5)
Weight:	pounds ounces
Head:	inches (e.g. – 15.5)
Chest:	inches (e.g. – 15.5)
Hair color:
Eye color:
Sex:	Boy Girl
Order of child in family:	(e.g. – ‘second’ if the baby is the 2nd child)
Section 3 - Baby's Features, the Pregnancy and Birth (For feature article)
Describe your baby's two most distinguishing features. [limit of 8 words per description]
1. 2. (e.g. - He had a full head of hair.)
Length of pregnancy:	weeks (F.Y.I: on time = 40 weeks)
Describe your pregnancy experience and emotions. [limit of 12 words per description]
1. 2. (e.g. - Mom craved Ben & Jerry’s Chunky Monkey ice cream.)
Length of labor:	hours
Describe what you were doing moments prior to the onset of labor. [limit of 20 words]	(e.g. – Mom’s water broke at home right after she woke up from a nap. We went to the hospital three hours later)
Describe your labor and delivery experience and emotions. [limit of 12 words per description]
1. 2. (e.g. - The pain was intense, but once the epidural took effect it was a breeze.)
Please describe your first thoughts and feelings upon seeing your baby. [limit of 8 words per description]
1. 2. (e.g. - We were happy to hear him cry and to see him healthy.)
Besides Mom and Dad, who else was there to welcome your baby? [limit of 2 other people]
1. 2. (e.g. - Grandma Louise)
City of birth:	(e.g. – Kansas)
State of birth:
Doctor's name:	(e.g. – Dr. Jones)
Hospital name:
Section 4 - Feature Article and Personal Message Selections
Article theme:	Hometown interview Sports Story
Click Here for Choices and Examples Click Here for a Full View of the Product
Personal Message Title: [if left blank, the default title will be used]
Personal Message: [limit of 75 words] [if left blank, the default message will be used]
3. Message Signature: [if left blank, the default signature will be used] (e.g. - Mom & Dad)
Section 5- All About Baby's Family
Parent Structure:	Dual Parents Single Mom
Mom's first name:
Mom's middle name:
Mom's last name:
Mom's birthday:	Month: Day: Year: (e.g. 2002)
Dad's first name:
Dad's middle name:
Dad's last name:
Dad's birthday:	Month: Day: Year: (e.g. 2002)
Father's Side
Grandma's name:
Grandma's birthday:	Month: Day: Year: (e.g. 2002)
Grandpa's name:
Grandpa's birthday:	Month: Day: Year: (e.g. 2002)
Mother's Side
Grandma's name:
Grandma's birthday:	Month: Day: Year: (e.g. 2002)
Grandpa's name:
Grandpa's birthday:	Month: Day: Year: (e.g. 2002)
Siblings
Number of siblings:
Sibling 1's name:
Sibling 1's birthday:	Month: Day: Year: (e.g. 2002)
Sibling 2's name:
Sibling 2's birthday:	Month: Day: Year: (e.g. 2002)
Sibling 3's name:
Sibling 3's birthday:	Month: Day: Year: (e.g. 2002)
Sibling 4's name:
Sibling 4's birthday:	Month: Day: Year: (e.g. 2002)
Section 6 - Shipping Information (If different from billing info)
First name:
Last name:
Street address:
Apt./Suite:
City:
State:
Zip code:
Phone:
E-mail:
Other information: Special Instructions or Notes [please indicate any special instructions or notes pertaining to your order]