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Milestones Submission Forms
Anniversary • Birth • Engagement • Senior Birthday • Wedding

Senior Birthday

The Times

We publish every 5th year, starting with 75 years (i.e. 75, 80, 85, 90) and any birthday after 90. Forms should be received at least two weeks prior to publication. A photo may be included, but must be good quality for reproduction in the newspaper. Mail or deliver this form to The Times, Senior Birthdays, 110 W. Jefferson St., Ottawa, IL 61350. The Times may not include all information at times. If you have any questions, call Bernadine at 815-431-4076, fax 815-433-1639 or e-mail bernied@mywebtimes.com. Please print clearly.

*Please fill in all fields. If there is no information available, please type in 'NA'

Name of person (include maiden):
Nickname(s):
Town person is living in:
Celebrating what birthday (age)?:
Date of birth:
Town where born and parents:
Spouse's name and date of marriage:
(Note if spouse is deceased):	Yes No
Number of children:
Names (spouse) and town:
Child 1: Child 2: Child 3: Child 4: Child 5: Child 6: Child 7: Child 8:
Number of grandchildren:
Names (spouse) and town:
Grand Child 1: Grand Child 2: Grand Child 3: Grand Child 4: Grand Child 5: Grand Child 6: Grand Child 7: Grand Child 8:
Number of great-grandchildren:
Number of great-great-grandchildren:
OPTIONAL INFORMATION TO BE PUBLISHED:
Occupation:
Hobbies:
Celebration planned: (Date, time and place):
Card shower:	Yes No
Celebrant's full address (to be published for card shower):
Person submitting form:
Daytime phone:
Your email address:
Picture?:

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