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 firstname.lastname@example.org.
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: _________________________________________________________
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)
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) ___________________________________________________________
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
Place and Address: __________________________________________________________________
ANNOUCEMENT AD AND PHOTOGRAPH PERMISSION CERTIFICATION
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: _________________________________
If the person signing above is under 18 years of age, please have a parent or legal guardian complete
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: ____________