Birth Announcement Submission Form for Publication in the
Naesmyth Cousins Newsletter
Omit any information you feel uncomfortable with.  However the more info, the more interesting the Birth Announcement.

Attention AOL Users:    Unfortunately, this submission form does not work for individuals using the AOL (America-On-Line) E-Mail program.  If you use AOL, please make note of the information requested below and simply E-mail it to:  Birth_Announcement@Naesmyth.com   - Thank You.

Newborn's - First Name    Gender   
            
Middle Name(s) 
                  
Last Name  
                Date of Birth  
                    Time of Birth  
                
Birth Weight  
                
Birth Length  
   Place of Birth  -  City   County  
                           State      or Province   (if not USA)
             Country of Birth
Is this Baby a Citizen of any other Country?  If Yes, Please select

    Number of infants in this birth (if more than single birth, submit additional infants separately)
If multiple Birth, This infant was to be born.
     This Birth was Attended by a
    Define "Other"   
This Birth took place in a     Please explain if not in a Hospital   
Was the Baby born "Early" or "Late"?    by weeks
Did Father witness the Birth? 

Was this Birth by Caesarian Section? 
Was this a Surrogate Birth (Adoption at Birth)? 


      Mother's - First Name    Is She the natural Mother? 
               
Middle Name(s) 
        
Last Name (maiden)  


       Father's - First Name    Is He the natural Father? 
               
Middle Name(s) 
                      
Last Name  


I have Photographs, Information and/or Articles which I would like to submit for publication.  Please contact me

Please provide any comments, suggestions, advice, ridicule or criticism (constructive or otherwise) below;
(This information will not be published)