Birth Announcement Submission Form

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(This information will not be published)