The Poem Shop

Quality customised Verses for Special People and Special Occasions

Customised Verse Order Form

After submitting this form you will not be requested to make any payment until I have reviewed your order.
A confirmation email will then be sent to the email address you provide containing your invoice and PayPal payment request.
This request will come in the form of a hyperlink to a secure payment form provided by PayPal where you can then enter your credit card details.
Once I have received confirmation of your payment I will produce and send your poem. We can then make any changes you require to get the finished product just as you want it.

Select a format for your customised poem:*

(PS01) Customised Poem by Email £30

(PS02) A4 Silver Framed Customised Poem £38

(PS03) Single Verse Personalised Greetings Card £5.50

(PS04) A4 Silver Framed Wedding Presentation Poem £38

Title:*

First Name(Include further names in this box if necessary):*

Surname:*

(You do not need to provide a postal address if purchasing just the email option)

Email Address:*

Street Number, Street Name:

Address Line 2:

City:

County/State:

Postal Code/ZIP:

Country:

Poem Details (Please provide plenty of information such as who the poem is for, type of occasion their interests/hobbies, family members, friends, personal background.):*

Deadline: (3 days minimum for emailed poem/7 days minimum for posted poem):*

Further Information/Comments (eg any special instructions or preferences):

(Please say how you found out about The Poem Shop):*

*(View Terms & Conditions)

I agree to Terms & Conditions of Sale: