Birthday Announcement

Instructions

Please fill out the information below. Attach a recent photo of the birthday person only.

The Record-Courier will run a photo/story about persons 70 years or older.

Birthday announcements are published when space allows. There are no guarantees as to when the birthday announcement will be published.

Please fill out the following fields

Age on birthday this year
Name
Date of birth (with year)
City/Township residence
Parents' names
City/state of birth
Number of years in Portage County
High school attended
College/military background
Employment history
Spouse's name
Date married (If spouse is deceased, date of death)
Children, their spouses, and places of residence (City, State)
Number of grandchildren
Number of great-grandchildren
Number of great-great-grandchildren
Hobbies
Church affiliations, club or group memberships
Date of party/celebration (Date, location, hosts, number attending)
Special/out-of-town guests (with towns and relationship to birthday person)
Special greetings received
Additional comments/instructions
Contact name *
Daytime phone number *
Submit Photo

Photo must be jpeg, jpg, gif or png and file size must be under 2 MB