DIY Happy Birthday Balloon Card. Or any celebration card. From the handmade house here.*Other cute ideas, especially altered book related ones.
DIY Inspiration Happy Birthday Banner (or whatever occasion you want) from SHinH catalog online at Flickr here. I love this idea because you can mail it to someone! You could package the letters in a DVD box and the String and clothespins as part of the wrapping or give them separately. So fun. Photos from the banner set here.