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Full name of poetry recipient: *
If for a friend, when, where and how did you meet? *
If for a family member, what relationship to you? *
Specific resolutions to be mentioned:
Special plans for the New Year you want to express:
Specific memories that make the past year stand out:
Do you want this to be a romantic message?
Humorous stories of the past year you would like to include:
List any other thoughts, facts, stories or memories you might wish to include in your gift of poetry for this person:
Goals accomplished this past year:
Special moments shared between you and this person during the past year:
Where, how and with whom will you be celebrating on New Year's Eve?
Particular people that have helped you this past year that you would like to mention:
Names, ages, and sexes of your fiancee's children, if applicable:
If romantic, what special words would you like to say?
Additional comments, notes or instructions that you would like our writers to consider in creating your gift of poetry: *
Particular hurdles that make you glad the New Year has arrived:
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: *
What makes this New Year's special for you or the recipient?
* Denotes required field
Physical traits of person (e.g., tall, hair color, eye color, strong, handsome, cute, intelligent, witty, talented, etc.): *
Character traits of person (e.g., supportive, loving, kind, thoughtful, caring,
hard worker, nurturing, unselfish, etc.): *
"special words for special people"
