Valentine Order

Submit your info to order a uniquely yummy poem for Valentine's Day!

Your Name *

First

Last

Your Email *

Please Indicate Poem Recipients First Name *

Recipients age and gender if you'd like that considered. *

What is their relation to you. (They are your wife, your boyfriend, your grandmother, your child, etc.) *

Is the poem being mailed back to you or directly to the recipient? *

To me To the recipient

The poem will have a tag indicating WHO the gift if from. What would you like it to say? It can say your name or something like "your loving daughter" or it can even say "Secret Admirer." Write exactly how you'd like it to read. *

Please indicate any info you would like considered in the creation of this poem. ie: details, character traits, memories, nicknames, hobbies, interests, physical traits like eye or hair color, something you love about this person, how you met, how long you've known each other, do you have a special song or place you've visited together, or any theme or specific sentiment you would like expressed or explored. *

How did you hear about this Valentines offer? *

Name and Address where you would like the poem to be sent *

Line 1

Line 2

City

State

Zip Code

Country

Any other special request? *

Submit