Birth Announcement

Please complete this form and press the SUBMIT button to send your Birth Announcement.   All birth announcements are handled through our receptionist at Heartland during office hours.  Your announcement will be handled within 1 business day.  If your request is urgent, please call the church office. During office hours, call (217) 877-9529, extension 0.  After hours, please use extension 150.

  1. Please provide the following contact information:

    Submitter
    Submitter's Work Phone (xxx) 123-4567
    Submitter's Home Phone (xxx) 123-4567
    Submitter's E-mail
    Enter the mother's name below: Enter the baby's name below:
    Enter the father's name below: Enter the baby's birth date below:
    -- mm/dd/yy
    What hospital? Enter the baby's height: Enter the baby's weight:

    If Other:
         		inches lbs   ounces

  2. I have read the  Heartland Community Church Privacy Statement and intend this information to be considered . . .

  3. I have read the Heartland Community Church Privacy Statement  and agree/do not agree with its terms.

  4. Comments:

Copyright © 2003 [Heartland Community Church]. All rights reserved.
Revised: 04/20/04