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:
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
____________________________________________________
Poems are printed on specialty paper created by the Poetess.
Added cost if you would like the poem printed on glossy photo paper ($3.00)
Paper size is 8.5x11 with a special border design created
to go with each poem. All poems are suitable
for framing
Pricing: All Personalized Gift Poems:
$29.00, this includes Shipping and Handling.
Now you can order your Personalized Poems through PayPal. Once payment has been verified you can email or fax your order
form to:
Fax# 770.879.1566 You
can also purchase by money order: Once
payment has been received along with your order form you
will receive a confirmation call.
Then once your poem has been approved by you and
final touches made, it will be mailed out the next business day. So make sure you order your poetry gifts in time for
that special birthday or anniversary etc.
Allow two weeks for delivery and this all depends on where
you are located in the United States.
Rush orders can be faxed or emailed when
paying through PayPal. Fax# (770.879.1566)
Please include your phone number and
email address so she can
verify receipt of your order form,and money order.
Make your money order out to:
Ruth Sadi El
Mail order form to:
Ruth Sadi El
5328 Kelleys Mill Circle,
Stone Mountain, GA 30274
Fax: 770.879.1566
Any problems printing this order form
just copy and paste then print out.
Thank you in advance for your purchase
