Order Form for your Customized Baby Birth Certificate

Your Twins Customized Birth Record in beautiful pastels!
     This decorative archival Birth Certificate includes the following:
* Babies' Photos     * Babies' Name and birth Information
* Babies' Family History
* Artwork by Award Winning Artist, Keith Freeman
* Poem by Sharon Lee     * Printed on Parchment or Ivory
* Fits any standard frame:  11"x14", 8"x10", and 5"x7" (Mat/Frame Not Included)

Contact Information
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
First Baby's  Information
First Name:
Middle Name or Initial:
Last Name:
Birthday:
Time:
Weight
Pounds:
Onces:
Length: Inches
Place of Birth:
City:
State:
 E-mailing 
Baby's Photo		 Please e-mail the image at 300 dpi to slee@babybirthcertificate.com with your baby's first and last name in the subject line.
 Mailing Baby's Photo If Mailing Baby's Photo:
Mail Photo to
Ten Tiny Fingers
ATTN: (Your Baby's First and Last Name)
P.O. Box 12688
Fort Wayne, IN 46864-2688
Second Baby's Information
First Name:
Middle Name:
Last Name:
Birthday:
Time:
Weight
Pounds:
Ounces:
Length: Inches
Place of Birth:
City:
State:
 E-mailing Baby's Photo Please e-mail the image at 300 dpi to slee@babybirthcertificate.com with your baby's first and last name in the subject line.
 Mailing Baby's Photo If Mailing Baby's Photo:
Mail Photo to
Ten Tiny Fingers
ATTN: (Your Baby's First and Last Name)
P.O. Box 12688
Fort Wayne, IN 46864-2688
Genealogy The Information below will appear on the certificate as submitted
Mother
First Name:
Middle Name:
Maiden Last Name:
Father
First Name:
Middle Name:
Last Name:
Maternal Grandmother
First Name:
Middle Name:
Maiden Last Name:
Maternal Grandfather
First Name:
Middle Name:
Last Name:
Paternal Grandmother
First Name:
Middle Name:
Last Name:
Paternal Grandfather
First Name:
Middle Name:
Last Name:
Purchasing Information Click on the package you want to purchase. 

 Package #1

 $49.95

1:

11x14 Parents

2:

8x10 Grandparents

4:

5x7 Aunts/Uncles

 

 
 Select Paper Type Ivory
Parchment
*Please select only one
Delivery: Please allow 4 to 6 weeks for delivery

 

 

NOTE:

Gift Certificate purchases are not available through this online option. Please return to the previous page and print off the order form for "Pay by Check, Money Order, and/or Gift Certificate".