SHORTER 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


				*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