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Brthday person's full name: *
Is poem for a friend or a family member? *
Is this person a male or a female? *
Do you want this poem to be serious, humorous, or a combination of both? *
Do you want this to be a romantic message?
Do you want this poem to be gentle but humorous or do you want it to chide this person about his or her birthday?
List any other thoughts, facts, stories or memories you might wish to include in your gift of poetry for this person:
Would you like to include a spiritual or religious theme?
Special moments shared between you and the birthday person during the past year:
Memories or acts of kindness you would like to acknowledge about this person:
What private joke or personal story, if any, you would like to include?
Names, ages, and sexes of your fiancee's children, if applicable:
Is this birthday a milestone and if so, which one?
Additional comments, notes or instructions that you would like our writers to consider in creating your gift of poetry: *
Birthday person's age or date of birth *
Your relationship to
poetry recipient: *
Your full name: *
Your mailing address: *
Daytime phone number and best time to call: *
Evening phone number and best time to call: *
Special instructions or comments and date poem is needed: *
* Denotes required field.
Provide us with the requested information about yourself.
Then complete the poetry information request form below as you are able. Remember, the more detailed the information you provide, the more personal and unique the gift.
Your email address: *
If for a family member, what is your relationship to him or her?
* Denotes required field
Physical traits of person (e.g., tall, hair color, eye color, strong, handsome, cute, intelligent, witty, talented, beautiful, etc.): *
Character traits of person (e.g., supportive, loving, kind, thoughtful, caring,
hard worker, nurturing, unselfish, etc.): *
If for a friend, how do you know this person? *
"special words for special people"
