The Date of your Birth
Year  (optional)
Your Mailing Address
State
Zip Code
Month
Day
Your Name

PLQ would like to help you celebrate that special Day !  

Simply fill in the simple form below, and we will send you a birthday greeting.  Of course the actual number can remain your secret !!.

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City
"Happy Birthday to You !
Happy Birthday to You !
Happy Birthday God Bless You,  Happy Birthday to You. ! "
March 4th- Peggy Bunch
March 9th- Anna Sheets
March 20th- Nathan Potts
March 21st- Glen Petersheim
March 24th- Janna Cather
________________________

April 9th- Nancy Pope
April 10th-Dixie Koser-
April 16th- CoWanda Gill
April 25th- Chad Hamman
April 27th- Tracy Bunch  
Please sign me up for the PLQ Birthday Club