Please print this form, fill it in, and mail it to the Observer-Reporter. From the information given, an account of the child's birth will be written. Please submit the announcement as soon as possible after the birth.
Observer-Reporter
Lifestyles Department
122 S. Main St.
Washington, PA 15301
| Name of parents | |
| Address | |
| Date of birth | |
| Hospital | |
| Sex of child | |
| Child's name | |
| Paternal (Father) Grandparents (if divorced or deceased, please specify) | |
| Address | |
| Maternal (Mother) Grandparents (if divorced or deceased, please specify) | |
| Address | |
| Mother's signature | Phone |
| Father's signature | Phone |
Signature of both parents is required in writing. If the parents are not married, this form must be notarized.