To place an order just print this form, and mail to or fax to address below. If you wish to use the ON LINE Order Form Click Here
We also carry books with favorite cartoon character, and favorite animated characters. These licensed books can not be listed on the Internet. We can send you a color brochure on the books at your request. For a Color Brochure E-Mail us your Name and Address.
NAME OF BOOK YOU WISH TO ORDER:_______________________________ CHILDS FIRST NAME:___________________________________ MIDDLE NAME: (optional)________________________________ LAST NAME: ___________________________________________ HOMETOWN: City_________________________ State __________________ Boy________Girl__________Age___________
NAME OF THREE FRIENDS OR RELATIVES OR PETS:
(1) __________________________________
(2) __________________________________
(3) __________________________________
Dedication Line:__________________________________________________________ (Example:) Merry Christmas, Happy Easter, Happy Birthday, To a Special Son, Person or Persons who are giving the Book: __________________________________________________________ As they appear in Book: (Grandma, Mom, Dad, or First and Last name, Uncle Mike, etc.) (This will be printed on the first & last page of the book)
Date of Birth: Month:_______Day:______Year:_______
Time of Birth:___________A.M./P.M. Baby's Weight: Pounds:________Ounces:___________Baby's Length: ____________ Delivered By: Dr.______________________________Hospital:_____________City:_______________ Mom's First and Last Name____________________________ Dad's First and Last Name______________________
Favorite Players:______________________________________ Winning Team: ________________________________________ Losing Team: _________________________________________
Name of Teacher: _________________________________________ Name of School: _________________________________________
Name_________________________________________________________________ Address________________________________________________________________ City, State, Zip___________________________________________________________ Phone(_____)________________ E-Mail address:_______________________________
(Above phone number is for questions I might have with your order, also write a contact person.)
Name on card:_________________Expiration Date_________Type of Card__________ Card Number:___________________________________________________________
Books sell for $16.00 Each, which includes tax and shipping: Your Total: $_____________
Make Check out and mail to: Children's Personalized Story Book Inc. 1444 South Lake Shore Drive Fowler, Illinois 62338 Phone 217-222-2965 or Fax 217-223-0126 E-Mail us at orders@neatpages.com
Return to Home Page Click here to see Description of Story Books