These questions will help you to give me a clear picture of what you want the content of your poem to be. Please take a few minutes to consider your responses because it will help me to more quickly create your poem. Don't worry if you don't have answers to all the questions - just fill in as much you can. Once I receive this form, I will contact you to claify details before I move forward.

Who, exactly, is the poem intended for?




Will the poem be read to the subject at a function?



 Is the poem intended for a group or a general audience?


 
What is the main message you want to send?



 Are there any funny stories about the subject that should be included or referred to?



 Are there any nicknames?



 What specific occurrences would you like to refer to in the poem?



 Are there any language concerns? Age, ability or content?




 Your name:   

Your email address:    

Your phone number: