Date of Birth: ________________________________
Date of Birth: ________________________________
Date of Birth: ________________________________
|
||
| Baby Information | ||
| Baby Sex: Male | Female | ||
| Baby First Name: _____________________________ | ||
| Baby Middle Name: ___________________________ | ||
| Baby Last Name: _____________________________ | Suffix: | Jr. | III | IV | V | other___________ | |
| Date of Birth: ________________________________ |
||
| Weight: _________ lbs. __________ oz. | ||
| Length: _______________________ in. | ||
| Time of Birth: ________ : ________ AM | PM | ||
| City of Birth: _______________________________ | ||
| * Twins Only - Second Baby | ||
| Baby Sex: Male | Female | ||
| Baby First Name: _____________________________ | ||
| Baby Middle Name: ___________________________ | Suffix: | Jr. | III | IV | V | other_________ | |
| Date of Birth: ________________________________ |
||
| Weight: _________ lbs. __________ oz. | ||
| Length: _______________________ in. | ||
| Time of Birth: ________ : ________ AM | PM | ||
| * Triplets Only - Third Baby | ||
| Baby Sex: Male | Female | ||
| Baby First Name: _____________________________ | ||
| Baby Middle Name: ___________________________ | Suffix: | Jr. | III | IV | V | other_________ | |
| Date of Birth: ________________________________ |
||
| Weight: _________ lbs. __________ oz. | ||
| Length: _______________________ in. | ||
| Time of Birth: ________ : ________ AM | PM | ||
| Billing Information | ||
| First Name: ______________________________ | Middle Name: ____________________________ | |
| Last Name: ______________________________ | Company: ___________________________________ | |
| Address: _____________________________________ | ||
| Address2: ____________________________________ | ||
| City: ______________________________________ | State: _______________________ Zip: __________ | |
| Phone: ( ) __________ - _____________ | Phone2: ( ) __________ - _____________ | |
| Email: _____________________________@__________________________________ | ||
| Shipping Information: Same as above Check here __________ | ||
| First Name: ____________________________ | Middle Name: ____________________________ | |
| Last Name: ____________________________ | Company: ___________________________________ | |
| Address: _____________________________________ | ||
| Address2: ____________________________________ | ||
| City: ______________________________________ | State: _______________________ Zip: __________ | |
| Phone: ( ) __________ - _____________ | Phone2: ( ) __________ - _____________ | |
| Email: _________________________@__________________________________ | ||
SAMPLE INVOICE
|
|||||
Date
|
Job#
|
REF# (found
on our website) |
Quantity
|
$ Price
|
|
08/12/05
|
1.
|
LS -
1 (found
on our website) |
xx
|
$xx.xx
|
|
|
2.
|
C-AB-2 (found
on our website) |
xx
|
$xx.xx
|
||
3. |
|||||
You can find your shipping rate on our
website
|
Shipping |
$x.xx
|
|||
Total |
xx
|
$xx.xx
|
|||
INVOICE
|
||||||
Please fill out this Invoice and submit with your package |
||||||
Date
|
Job#
|
REF# (found
on our website)
|
Quantity
|
$
Price
|
||
|
1.
|
|
|||||
2. |
||||||
3. |
||||||
4. |
||||||
5. |
||||||
|
*
|
For Additional jobs please write on back of form. | Shipping
|
||||
Total
|
||||||
*All Orders paid by check will be completed
and shipped when the check has cleared the account. Most orders are shipped within 7 business days. Did you remember to... 1. Proof read all material. We are not responsible for errors. 2. Enclose photograph(s) 3. Signed check with correct amount. Send your package to us now to the address below! PJBDesigns Mailing address will be coming soon! Thank You. Close this window |