WIFR Birthday and Anniversary Submission

Birthday and Anniversary Submission

Use the form below to submit your birthday and anniversary announcements! Please submit your requests at least two weeks in advance. Daily winners receive a $10 Lino's gift certificate. Winners are chosen randomly and must be at least 18 years of age.
Are you submitting this form for a birthday or an anniversary? *

Birthday Anniversary
Name for Anniversary Couple or Person Celebrating Birthday *

First Name Last Name
First Name Last Name
Enter the date of the celebratory event: *
Address for Anniversary Couple or Birthday Person *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Enter your contact information (optional)

First Name Last Name
Email
example@example.com
Phone Number

Area Code Phone Number
I would like to receive information from trusted partners in the following categories:

Automotive Coupons Entertainment/Travel Gifts/Jewelry Health & Wellness Home Improvements Lawn Care Restaurants Salon & Spa Services
Please enter your date of birth. *

Month Day Year
You must be at least 18 years of age to submit this form.
Terms and Conditions

I have read, understand, and agree to the Website usage agreement and privacy policy.
*

I Agree to the Terms and Conditions
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