| Recipient's Name: |
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| Age: |
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| Your Name: |
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| Your Email Address: |
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| Your relationship to recipient: |
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Reason for poem?
e.g. Wedding, Anniversary, Birthday |
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What is the recipient like?
Kind, Shy, Loud, Bossy, Caring |
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Memorable times or incidents you would like included in the poem.
The more information you provide the more personal the poem can be. |
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Tone of poem you would like?
Funny, Serious, Romantic, Sad or a mixture of these. |
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If you wish the poem to be humorous, how funny can it be without causing upset to the recipient?
Please give details of the person's personality and sense of humour to avoid offence. |
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| What do YOU want to say in this poem? |
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| Any additional information you would like included? |
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| If the poem is to celebrate a special event, what date is the poem required for? (DD/MM/YYYY) |
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