A Special Poem Needed

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I'm sorry to say that a few people that have filled out this form have not recieved their poems due to my not having the correct email address on them. Their poems have been written, so if you have filled out this form and have not been answered or if you fill it out and do not hear back from me with in 48 hours, please email me at, poetforjesus@yahoo.com and this way I will be given your email address again. Thank you so much and may God bless! Cathy Jo Moore

Please answers these questions

Please give your name:

Please enter your e-mail address:

If you have a web site please give the url.

Please give the name of the person the poem is for:

If the person you want the poem for
has a web site please give their url.

1) Are you male or female?: Male; Female

2) Is the person you want the poem for male or female?

Male

Female

3) How old are you?: Under 18 years old; Between 19 and 24 years old; Between 25 and 34 years old; Between 35 and 44 years old; More than 45 years old

4) How old is the person the poem is for?: Under 18 years old; Between 19 and 24 years old; Between 25 and 34 years old; Between 35 and 44 years old; More than 45 years old

5) What do you want the poem for? If he or she is related to you please say how in your comments.: Just Because; Birthday; Anniversary; Graduation; Love

6) How often do you visit with this person?: Every Day; Once per week; Once per month; Once per year

7) What is your favorite thing to do with this person?: You may select more than one.; Go out to eat; Shopping; Movies; Dancing; Stay at home and relax

8) Please provide as much information about your relationship with this person.
Many times we are able to sign the poem as your own words that have been rearranged by...

9) What do you think about this site?