Births

General Information

Person Submitting Form

Local Phone *

Contact E-mail *

Child's Name (first, middle and last name, in that order)

Gender

Date of Birth (format XX/XX/XXXX)

Mother's Name

Father's Name

Address 1

Address 2

City

State

Zip

Siblings

Brothers and ages

Sisters and ages

Living Grandparents

Living Maternal Grandmother

Address 1

Address 2

City

State

Zip

Living Maternal Grandfather *

Address 1

Address 2

City

State

Zip

Living Paternal Grandmother

Address 1

Address 2

City

State

Zip

Living Grandfather

Address 1

Address 2

City

State

Zip

Living Great-Grandparents

Living Maternal Great-Grandmother

Address 1

Address 2

City

State

Zip

Living Maternal Great-Grandfather

Address 1

Address 2

City

State

Zip

Living Paternal Great-Grandmother

Address 1

Address 2

City

State

Zip

Living Paternal Great-Grandfather

Address 1

Address 2

City

State

Zip

Naming of Baby

Baby's Hebrew Name

Named in Memory of

Anything else we should know?

I will also send a photo to Chronicle@MilwaukeeJewish.org, which may be used in print and on our website (not Facebook or social media).

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General Information

Siblings

Living Grandparents

Living Great-Grandparents

Naming of Baby

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