Print this DATES AND EVENTS form (3 pages) and mail it with your photos to
Townsend Sorghum Mill.Com
326 Pilgrim Road
Abilene, TX 79602
Phone: (866)275-2824 or Local: (859) 497-0270

Name: ______________________________________________ Order ID :______________________________________
Phone: ______________________________________________ Starting Month ___________  Year__________

Print or Type Clearly ... Use another sheet of paper as needed for additional months or for clarity.

Captions for each Month (You may specify location) Front Cover Message (May include a photo and/or personal message)
Jan.  
Feb  
Mar.  
Apr.  
May  
Jun. Back Cover Message
Jul  
Aug.  
Sept.  
Oct.  
Nov.  
Dec.  

The use of copyrighted materials is illegal and must be authorized by the owner of the copyright.
If you send copyrighted photos, you must have this form signed by the photographer or owner of the photos.


I, _________________________________________________(print name of copyright owner) hereby represent that I am the owner of all rights to the materials requested for reproduction by Townsend Sorghum Mill.com. I hereby release Townsend Sorghum Mill.Com from any and all liability that may result from possible copyright infringement.

                Authorized Signature  ______________________________________________________ Date ___________________


List all your special dates and events for your personalized calendar. We allow 30 names or events at no additional cost. If you wish to have more than 30, you must indicate so on your order and submit the required fee of $8.00 per 30 added events. Major US Holidays are automatically included on each calendar except as specifically requested. We include clipart on holidays, birthdays and event when possible. If you DO NOT want clipart on your calendar you must write NONE in the clipart column.  If you would like some particular clipart you may request it and we will add it if possible.  Our default clipart for birthdays is balloons, cakes, banners; the default for anniversaries is a banner, hearts or rings.

Month Day ClipArt Occasion (example: Johnny's Birthday, Mary & Tom's Anniversary, Graduation Day)
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       

Place your photographs, this form, any other instructions, and your payment (unless you paid by Credit Card)
 in an envelope with sheet of cardboard or other stiff paper. Mail to:  
Townsend Sorghum Mill.Com   326 Pilgrim Road, Abilene, TX 79602
 If you need to send your package by UPS, FedEx, Etc. the address is: 326 Pilgrim Road, Abilene KY 79602

Month Day ClipArt Occasion (example: Johnny's Birthday, Mary & Tom's Anniversary, Graduation Day)
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       
       

Place your photographs, this form, any other instructions, and your payment (unless you paid by Credit Card)
  in an envelope with sheet of cardboard or other stiff paper. Mail to:  
Townsend Sorghum Mill.Com   326 Pilgrim Road, Abilene, TX 79602
 If you need to send your package by UPS, FedEx, Etc. the address is: 326 Pilgrim Road, Abilene KY 79602