My Baby Book Order

ORDER FORM

Book Title: My Baby Book

Child's First, Middle (optional) & Last Name:______________________________

Child's Nickname (optional):_____________________________________________

Sex:__________

Age (optional): __________

Child's Hometown & Province:____________________________________________

Names of Three Friends/Relatives:_________________________________________

This Book is From:_______________________________________________________

ADDITIONAL INFORMATION

Date of Birth: Month_____/ Day_______/Year________

Time of Birth:______________ AM PM

Baby's Weight: Pounds:______ Ounces: ________Baby's Length:_____________

Delivered By:______________________Hospital:____________________________

Mom's First Name:___________________ Dad's First Name:__________________

Note: This book is available in "single" mom or "single" dad version. Please check the box below if applicable.

"single" mom version "single" dad version

MAIL BOOK TO:

Name:________________________________________________________________

Address:_______________________________________________________________

City:_________________ Province: ____________ Postal Code:_________________

In case of questions on your order, please fill in the following optional information.

Phone Number:_(_____)_______________Email address:______________________

Price of Book……………………………………………………………………… $CAN 19.95

Shipping & Handling..............................……………………………………….. $CAN 6.00

TOTAL………………………………………………………………………………..$CAN 25.95

PLEASE PRINT OUT ORDER FORM AND MAIL WITH CHECK PAYABLE TO:

Helda's Art Touch

Box 21171 R.P.O. Meadowvale

Mississauga, Ontario L5N 6A2

We thank you for your order and want you to know that your satisfaction is guaranteed.