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EXPLOSIVE RHYMES BY RUTH

SHORT FORM














Explosive Rhymes By Ruth | SAMPLE POEMS | Specialty Paper | About the Poetess | Mission Statement | Poem Order Form | Short Order Form





 
Ordered by:
Name: __________________________
Address: ________________________
City:__________________State: _____
Zip: ______
Phone: ______________  Fax: _____________
E-Mail Address:_____________________
 
Poem Created For: (daughter, son, mother, friend, etc.)
Name:_________________   Nickname:____________
 
(Where the poem will be shipped)
Address:_____________________________
City:_________________St:______Zip:_______
What's the occasion:______________________
(anniversary, birthday, friendship etc.)
Age:____
Sex:  M___  F___
Physical Description - eye color,  hair color, height, etc.
______________________________________________
Special words:_________________________________
Name an event you want included:_________________
______________________________________________
Special Moment(s) you want added:________________
______________________________________________
What else would you like me to know about your special
person:________________________________________
_______________________________________________
Anniversary date:___________
Birthdate:__________________
Special date to be added: __________________
If you have anything else you would like for me to include
about your special someone just add below:
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
 
Mail this form along with your payment to:

Ruth Sadi El
5328 Kelleys Mill Circle 
Stone Mountain, GA 30088
 
If you have problems printing off this form just copy and paste order form into word document etc., and print off. Any questions send to ruthsadiel7@gmail.com