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100 Year Birthday Celebration or
50th, 60th, 70th Wedding Anniversary
Persons name
Please include both names if it is an anniversary request.
First name
Last name
Date of Birth
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Contact details are required below
Email address
Show on directory ?
Cell phone
Show on directory ?
Person or Household Address
Address line 1
Address line 2
Address line 3
Address line 4
Town/Suburb
City
Postcode/Zip
Anniversary Date: Please indicate the celebration using the tick-box below.
100th Birthday
50years
60years
70years
Please check the highlighted fields
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