Poetry on Demand

"Quik" Information Form
First Name
Last Name:
Street:
City:	State:	Zip:
Email:
Poetic Topic/Subject
1. Who or What is this topic about? If you want the name included, please use correct spelling.

2. Please write what you want to see in this poem, concerning the topic (i.e. this person loves horses, golf or ice cream/this person loves to make you laugh)

3. If the topic is a place or thing, be specific: For instance…Salt Lake City, Nevada or a Siberian Tiger.

4. Is there a specific sentence or phrase that you would like to see in the poem? Such as “The Manual Bulldogs have the biggest bark! And our bite’s not too bad either.”

*Price:$19.95 plus $1.50 for tax/S&H. Write checks/money orders to TCBS’ Poetry On Demand. Satisfaction Guaranteed! 7 day or less turn around. Phone: (757) 513-7777, Fax:(757) 671-7740, E-mail: Jacquelinesbooksforkids@yahoo.com.

"Quik" Information Form