Note: All fields are required for submission.
ABOUT YOUR BEAUTIFUL BABY
Baby's Date of Birth (mm/dd/yy):
Date Picture was Taken (mm/dd/yy):
Nominator's relation to child:
Daytime Telephone #:
Evening Telephone #:
Cell Phone #:
YOU MUST SUBMIT A PHOTO OF YOUR BABY WITH THIS QUESTIONNAIRE TO BE CONSIDERED.
To attach your file, click BROWSE above, locate the file on your computer in the pop-up dialog and push OPEN.
Format your digital photo as a .JPG or .GIF.
The size of your formatted photo file should be 100K or smaller.
Photos will NOT be returned.