BEASTAR BOOKS

"A SPECIAL DELIVERY"

BOOK ORDER FORM


PURCHASER'S INFORMATION
	Purchaser's Full Name
	Your Email *
PERSONALIZED INFORMATION TO INSERT INTO THE BOOK
	Baby's full name
	Gender
	Baby's Father
	Baby's Mother
	Baby's Date of birth
	Time the baby was born
	Baby's weight
	Baby's length
	Friends who visited the baby in the hospital
	Name of the hospital where the baby was born
	Name of the doctor (or midwife) who delivered the baby
MAILING ADDRESS TO WHERE THE BOOK WILL BE SENT
	Mail to:
	Mailing Street Address
	Mailing City
	Mailing State
	Mailing Zipcode
BILLING ADDRESS
	Is the Billing Address the same as the Mailing Address?	Yes No
	Bill to:
	Billing Street Address
	Billing City
	Billing State
	Billing Zipcode
*Required Field The information collected on this form is confidential and will not be given or sold to anyone other than the recipients specified above. Any questions or concerns can be emailed to beastarbooks@propertycure.com.
Please Click Only Once.