Birth Date With Panda - Personalised Recycled Rimu Wall Art

Person's name as you would like it to appear*

Date of Birth (dd/mm/yyyy)*

Time of Birth (eg. 10:26pm)*

Town or City of Birth (Optional)

Optional features (max 3) Star Sign Chinese Star Sign Birthstone Birth Weight Birth Length

Birth Weight or Length (if selected above)

Comments

Email address which you would like a proof sent to prior to engraving*