Anniversary Announcement

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Anniversary Announcement Powered By Docstoc

          To have your announcement published in the Kalamazoo Gazette, this form, photo and payments must
be received at the Gazette at least (4) four weeks before the requested Saturday publication.
          For photos, we require studio-quality, head and shoulder shots. Digital color or Black and White photo
files or original prints may be used. Polaroid images are not acceptable. The Gazette reserves the right to reject
any inappropriate photo or photos of poor quality.
          You may pick up the print at the Kalamazoo Gazette after publication or you may supply a self
addressed stamped envelope for the return mail.
          Please print or type, using both capital and lower case letters for clarity. Use given names or two
initials, not nicknames. Street addresses are not necessary. Only city and state will be published. Please be
accurate and complete. Legibility is necessary.
          For more information call 269.388.7071 or email
Please return this form to: The Kalamazoo Gazette, Celebrations Editor, 401 S. Burdick St., Kalamazoo, MI.
49007 or fax to 269.388.8406

Information required for publication:

Requested publication date: _________________________________________________________

Name: __________________________________________________________________________

Address: ________________________________________________________________________

City: ________________________________________ State: ________ Zip: _________________

Telephone (8am -5pm) _____________________________ Home: __________________________

E-mail address: ___________________________________________________________________

Please select the announcement you wish to publish in Black and White or color.
(No additional charge for color)

Kalamazoo Gazette:       2 col x 5 inch ($35.00)          2 col x 10 inch ($70.00)

Hometown Edition:        Portage - 2 col x 5 inch ($25.00)  Commercial Express – 2 col x 5 inch ($25.00)

Payment Method:

 Check: __________________________________

 Visa: ___________________________________________________ Exp Date: _______________

 Mastercard: ______________________________________________ Exp. Date: _______________

 Gift Certificate: ___________________________

Cardholder’s Name: (please print) ___________________________________________________

Cardholder’s Signature: ___________________________________________________________
                                Information about the Couple
                                      (Please print clearly)

What anniversary is it? ____________________________________________________________________

Husband’s Name: (First, Middle, Last) _______________________________________________________

Employer:_____________________________________ Position: ____________________________ Retired

Wife’s Name: (First, Middle, Last) ___________________________________________________________

Employer:_____________________________________Position:_____________________________ Retired

Current Address (City/State only) City: ____________________________________ State: ________

                               Information about the Marriage
Date of Marriage: ___________________________________________________________________

Location: (City, State) ________________________________________________________________

Children and Spouses:

              Names                                            City and State

_______________________________________________ ________________________________

_______________________________________________ _________________________________

_______________________________________________ _________________________________

_______________________________________________ __________________________________

_______________________________________________ __________________________________

Number of Grandchildren: _________________________ Great-Grandchildren: _________________

                               Anniversary Observance Plans
Event: _____________________________________________________________________________

Date: _____________________________________________________________________________

Place and Address: __________________________________________________________________


       By signing this, I certify that I have obtained permission from whoever took the photograph(s)
and/owns the copyright in the photograph(s) being submitted, as well as permission from the person(2)
whose photograph(s) and name(s) appear in the announcement, and all other permissions necessary to
exclusive right to publish the attached announcement ad (including all photographs and names
contained therein) in the newspaper in any current and future media, including in the form of
individual reprints sold to the public. I agree that the Kalamazoo Gazette is not responsible for any
photographs that are damaged or not returned and consent to the photographs being cropped or
otherwise modified. I understand that this acknowledgement does not restrict whatever the Kalamazoo
Gazette has by law.

         By signing this, I also agree not to make or authorize any legal claims, and agree to assume all
liability for and indemnify the Kalamazoo Gazette, its affiliates, successors, and assigns from any and
all claims arising out of the publication or other use of the announcement (or any photographs or other
information contained therein), including but not limited to any claims for defamation, invasion of
privacy, or copyright infringement. Except as may be modified herein, all announcement ads are
subject to the newspapers rate card terms and conditions, which are incorporated herein by reference
and a copy of which is available on the newspaper’s website.

Name: _______________________________________________ Date: _____________

Relation to the subject(s) of the Announcement: _________________________________

Signature: _______________________________________________________________

Address: ________________________________________________________________


If the person signing above is under 18 years of age, please have a parent or legal guardian complete
the following:

I, the undersigned, being the parent or legal guardian of the person whose name appears above, do
hereby consent without reservation to the release and uses described above.

Name: ________________________________________________ Date: ____________

Signature: _______________________________________________________________

Address: ________________________________________________________________



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