Please fill out one of these forms for each design. Your name Shipping address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware D.C. Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Phone number E-mail address
Magnet Pin Single order (two copies) Bulk order Quantity: select a quantity 25 ($29.95) 50 ($39.95) 75 ($49.95) 100 ($59.95)
Event:
Name of baby or babies, if known:
Other info about the event that could make the magnet fun, funny, or poignant:
Do you have a head-and-shoulders photo (or several) of the person? Yes No
Print Digital
Do you have any other relevant photos? Yes No
If so, briefly describe: