Order Form for your Customized Baby Birth Certificate Scrapbook Page

This decorative archival Birth Certificate includes the following:
* Baby's Photo     * Baby's Birth Information
* Baby's Family History (Genealogy)
* Artwork by Award Winning Artist, Keith Freeman
* Poems by Sharon Lee
* Standard 12"x12" Scrapbook Page

Contact Information
First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code: (5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Choose your custom scrapbook option

 

 Adopted Baby Scrapbook Page

 Single Baby Scrapbook Page

 Twin Baby's Scrapbook Page

 

 Triplet Baby's Scrapbook Page
Paper Options

 

 Soft White

 

 Parchment
First Baby's  Information
First Name:
First Baby Middle Name or Initial:
First Baby 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
Custom Scrapbook Page
P.O. Box 12688
Fort Wayne, IN 46864-2688
Second Baby's Information If applicable
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
Custom Scrapbook Page 
P.O. Box 12688
Fort Wayne, IN 46864-2688
Third Baby's Information If applicable
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
Custom Scrapbook Page
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 One 12"x12" Scrapbook Page: $24.95 
 
Payment Options

 

 To Pay by Check, Money Order, or Gift Certificate
Print this form out and mail with your check or money order to:
Ten Tiny Fingers
Custom Scrapbook Page
P.O. Box 12688
Fort Wayne, IN 46864-2688

 

 To Order with PayPal (Gift Certificate purchases are not available through this option)
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".