Please print this form, fill it in, and mail it to the Observer-Reporter. Please include this signed form, a photo if desired, and your check or money order for $30. The announcement will be wrtten from the information provided and printed as space permits.
Observer-Reporter
Lifestyles Department
122 S. Main St.
Washington, PA 15301
Photographs: Please enclose a recent photograph of yourself if you are 75 or older. The photo will be returned only if a self-addressed, stamped envelope is provided and the name and address are written on the back of the photo. Photos also may be picked up in the Lifestyles Department up to six months after publication.
| Name | |
| Address | |
| Date of birth | |
| Location of birth | |
| Spouse | Date married |
| How birthday is being celebrated | |
| Children and their addresses
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| Grandchildren (names only)
|
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| Great-grandchildren (number only) | |
| Hobbies, activities and past employment
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| Signature | Phone |