POEM QUESTIONNAIRE
Loving Lines and More
www.lovinglinesandmore.com
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If you wish to purchase a personalized poem, please complete the below Questionnaire and click "Submit". As soon as we receive your Questionnaire and payment, we will start creating your poem. The more information you give, the better the poem will be. Please do not enter any information that you do not want in the poem.
Your Name:
Street Address:
City, State:
Zip:
Email:
Phone:
(1) If we should have questions, what is the best way to contact you?
(2) Who is the Recipient of the poem? (This name will be written as the Title of the poem).
(3) What is the Recipient’s gender?
(4) What name or names do you want written at the bottom of the poem? (This is the Giver of the poem).
(5) What is the relationship of the Giver to the Recipient? (Example: Brother, Sister, Mother, Daughter, Son, Friend, Boss, etc.)
(6) How long has the Giver known the Recipient?
(7) What is the occasion of the poem, if any?
(8) Please describe some times that are memorable regarding the Recipient. (Example: childhood memories, fun times, sad times, embarrassing moments, accomplishments, etc.)
(9) How does the Recipient make the Giver feel? (Example: loved, special, cared for, humbled, inspired, etc.)
(10) What is the Recipient like? (Example: kind, funny, loving, shy, outgoing, smart, witty, loud, strong, etc.)
(11) What do you want the tone of the poem to be (Example: funny, serious, sad, or a mixture)?
(12) Is there any kind of closing line you want written on the poem? (Example: Happy Birthday, Happy Retirement, Congratulations, I love you, etc.)
(13) Is there anything listed above that MUST be in the poem, or anything else you would like to add?
(14) Please choose your color of lettering and design below and click "Submit".
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