Your Name

Your Street Address

Your City, State, Zip

Your Phone Number

Your Email

Child's Full Name (middle name is optional)

Child's Nickname (optional)

Child's Age (optional):

Boy or Girl

Hometown & State

Names of up to 3 friends/relatives to include in story: (or up to 55 charactors/spaces)

Dedication lines for front of book  (You may have one line before who book is from and one after, limit of 35 characters and spaces per line)

Example:  To a special granddaughter, from

                  Grandma & Grandpa Jones

                  with lots of love!

First Line:   , from

Book is from:

3rd Line: