Judy's Precious Memories Order Form

Send Check or Money Order to:

Judy's Precious Memories
2440 Falcon Ave.
White City, OR 97503
(541) 826-2223

For Wedding, Anniversary and Graduation announcements, please send me a copy, via, email or snail mail. If origional copy is sent, it will be returned.


First Name:___________________________________ Mi____________

Last Name:___________________________________

Address 1:____________________________________ PO Box:_______

Address 2:____________________________________

City:___________________________________________

State/Province:_______________________________________________

Zip/Postal Code:_______________________________

Country:________________________________________

Email Address:______________________________________________________________________________

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Please Check Pillow Request:

Wedding______ Birth_______ Anniversary_______ Graduation_______

Boy________ Girl_________

Name on Pillow_________________________________________________________________

Date of Birth____________________________________________________________________

Time of Birth____________________________________________________________________

Pounds and Ounces_____________________________________________________________

Length___________________________________________________________________________

Parents First Names______________________________________________________________