Information on this form will be published one time in the Charles City Press for $7. We will contact you to arrange payment. Payment must be made prior to publication.

Name of Celebrant*
Residence City & State
Birthdate
Age
Type of Celebration
Celebration Date
Celebration Hours
Celebration Location
Hosted by
Address for Card Shower
Spouse
Children's Names and Towns:
Grandchildren #
Great-Grandchildren #
Great-Great-Grandchildren #
Optional: Upload a photo. Max file size 3MB. JPG, JPEG or PNG format.
Check the box below to purchase a Birthday Celebration Ad, with border and personalized message, starting at $36.66. Example: Lordy Lordy look who's 40, or Happy Birthday Grandma! We will contact you for details.

Contact Information -Your contact information will not be published.

Name:*
Address:*
Phone:*
-
E-mail:*
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