ORDER FORM
PLEASE PRINT CLEARLY
Name_________________________________________________________________
Address_______________________________________________________________
City, State,
Zip__________________________________________________________
Email_________________________________________________________________
Phone_______________________________
As you look at the
index, you will see that there are multiple children from one family on a
page. Please only list one child's name and that page number once when
ordering a copy of these records. You may list additional names on the back of
this page.
Child's
Name_______________________________________________Page_____________
Child's
Name_______________________________________________Page_____________
Child's
Name_______________________________________________Page_____________
Each ‘copy’ will include the left and
right hand page of the entry as well as a copy of the cover of the registry. The cost
for 1 ‘copy’ is $5.00. The cost for 3 ‘copies’
is $10.00. This includes the copies requested and
the postage.
Please send this form with your check or money order payable to:
BCHS
Please allow 2-3 weeks for receipt of these copies.
Thank You!