Forms Contact Form Contact Form First Name* Last Name* E-mail* Phone Subject Message* Submit Email: starlightverse@gmail.com Graduation Form Graduation Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Email Address* Customer Phone Number Recipient First Name Recipient Last Name Recipient Nickname Recipient Date of Birth Recipient Place of Birth Names and relationships of significant people to be included(family members, friends, significant others, etc.) Descriptions of significant events to be included Your emotional reflection of the recipient(what do YOU feel) Special Quirks Milestones Hobbies and Interests How you met?/Relationship Special memories that you share Recipient's favorite food, color, form of entertainment First word that comes to mind when you think of the recipient If the recipient were a color, what color would they be? If the recipient were a season, what season would they be? What do you see/hope for the recipient's future? If you could grant the recipient 1 wish, what would it be? Any additional information Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included. Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 1 Page Poem Printed on Stationery in Black and White---$30.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit Father’s Day Form Father\'s Day Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Phone Customer Email* Customer Date of Birth Recipient First Name Recipient Last Name Recipient Nickname Recipient Place of Birth Recipient Date of Birth Names and relationships of significant people to be included(children, siblings, etc.) Emotional Reflection of Recipient(What do YOU feel?) Description of Significant Events Special quirks or traits Milestones in recipient's life Milestones in customer's life that were shared with the recipient Hobbies and interests of recipient Hobbies and interests shared by the customer and the recipient How you met?/Relationship(indicate if the poem is not for YOUR father) Special memories that you share Inside Jokes/Funny Stories Recipients favorite food, color, and form of entertainment First word that comes to mind when you think of the recipient If the recipient were a color, what color would they be? If the recipient were a season, what season would they be? If you could grant the recipient 1 wish, what would it be? Any additional information Tone of poem(humorous, serious, somewhere in between) Would you like the poem to rhyme* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit Birthday Form Birthday Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Phone Customer Email* Recipient First Name Recipient Last Name Recipient Nickname Recipient Place of Birth Recipient Date of Birth Relationship to Recipient How you met? Names and relationships of significant people to be included Emotional reflection of recipient(What do YOU feel?) Description of significant events to be included Special quirks/traits of recipient Milestones Hobbies and Interests Inside Jokes/Funny Stories Special memories that you share Recipient's favorite food, color, form of entertainment First word that comes to mind when you think of the recipient If the recipient were a color, what color would they be? If the recipient were a season, what season would they be? If you could grant the recipient 1 wish, what would it be? If the recipient were a cake, what flavor would they be? What do you see/hope for the recipient's future? Any additional information Tone of Poem(humorous, serious, somewhere in between) Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit Holiday Form Holiday Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Phone Customer Email* Holiday/Occasion Date of holiday/occasion Recipient First and Last Name(indicate if recipient is a large group) Recipient Nick Name Recipient Place of Birth Recipient Date of Birth Relationship to Recipient Names and relationships of significant people to be included Description of significant events(memories from holidays past) Holiday Traditions Emotional reflection of recipient during this holiday(what do YOU feel?) Sights associated with this holiday Sounds associated with this holiday Smells associated with this holiday Tastes associated with this holiday Textures associated with this holiday Holiday memories unique to you and your family Colors associated with holiday Weather during holiday If the recipient were a color, what color would they be? If the recipient were a season, what season would they be? Tone of Poem(humorous, serious, somewhere in between) Any additional information Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry This may include sales, giveaways, and other promotions. Submit Poem for a Special Someone Form Poem for Someone Special Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Email* Customer Phone Recipient First Name Recipient Last Name Recipient Nick Name Recipient Place of Birth Recipient Date of Birth Relationship to Recipient Length of Relationship How/When you met? Names and relationships of significant people to be included Emotional Reflection of Recipient(What do YOU feel?) What do you love most about the recipient? Special Quirks/Traits Descripition of significant events to be included Milestones Together Hobbies and interests of recipient Hobbies and interests that you share Inside Jokes/Funny Stories Is this for an anniversary? If so, what year? Special memories that you share Recipient's favorite food, color, form of entertainment What is the first word that comes to mind when you think about the recipient? If the recipient were a color, what color would they be? If the recipient were a season, what season would they be? What do you see/hope for your future with the recipient? If you could grant the recipient 1 wish, what would it be? Any additional information Tone of poem(humorous, serious, or somewhere in between) Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 photos to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit Where I’m From Form Where I\'m From Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Email* Customer Phone Recipient First Name Recipient Last Name Recipient Nick Name Recipient Place of Birth Recipient Date of Birth Subject of Poem(Where WHO is from) Subject Hometown Names and relationships of significant people to be included(parents, siblings, etc.) Ordinary items found in childhood home Description of the subject's childhood home Description of neighbors and the neighborhood Plants associated with the subject's childhood Description of family traditions Family sayings and things that the subject was told as a child Family Traits Family Tendencies Sights associated with the subject's childhood Sounds associated with the subject's childhood Smells associated with the subject's childhood Tastes associated with the subject's childhood Textures associated with the subject's childhood Subject's favorite food as a child Inside Family Jokes/Stories Most valuable thing the subject was taught as a child Subject's favorite season as a child Subject's favorite color as a child Any additional information Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit General Poem Form General Poem Form(the more questions you answer, the better the experience) Customer First Name* Customer Last Name* Customer Address Customer City Customer State Customer Zip Code Customer Email* Customer Phone Recipient First Name Recipient Last Name Recipient Nick Name Occasion Subject of Poem Theme of Poem Significant Places Significant people to be included Colors associated with the subject Sights associated with the subject Sounds associated with the subject Smells associated with the subject Tastes associated with the subject Textures associated with the subject What is the first word that comes to mind when you think of the subject? Significant memories/stories associated with the subject Emotional reflection of the subject(What do YOU feel?) Any additional information Tone of Poem(humorous, serious, somewhere in between) Would you like the poem to rhyme?* Yes No It does not matter If you are purchasing a Presentation Ready Slide Show, please include a minimum of 15 pictures to be included Upload Poem Format 1 Page e-poem---$20.00 2 Page e-poem---$25.00 Presentation Ready Slide Show---$50.00 1 Page Poem Printed on Stationery in Color---$35.00 I consent to having part of, or my entire poem used by Starlight Verse Custom Poetry under our Sample Work Page(names will be removed) I would like to receive further communication of any news regarding Starlight Verse Custom Poetry. This may include sales, giveaways, and other promotions. Submit Testimonial Form Testimonial Form First Name* Last Name* Email* Subject* Message* I wish to leave this review anonymously * Submit
