Birth submission form

The Gresham Outlook

( denotes required fields.)


General information

Baby’s name:

Baby’s gender:

Male Female

Mother’s name:

Father’s name:

Address:

Date of birth:

Time of birth:

Place of birth (include name of site, city & state):

Birth weight:

Brothers and sisters (with names and ages):

 

Grandparents

Paternal grandparents’ names:

Paternal grandparents’ hometown(s):

Maternal grandparents’ names:

Maternal grandparents’ hometown(s):

 

For us to contact you if necessary

Contact name:

Contact phone:

Contact email:

Security Question 2+3=:

 

Click here to send photos for announcments via email. Be sure to include your name and contact information in the email so that we may get in touch with you if we have any questions.