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PLEASE FILL OUT THIS FORM TO
RECEIVE YOUR FREE PERSONAL POEM!
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Name
*
Email
*
You may opt to receive your poem as a PDF via email. If you would prefer this, you do not need to fill out the address form below.
What was the event you attended?
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What address is the poem going to?
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City
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If you would like you poem mailed to you, please enter a mailing address. This address will not be used for anything other than sending you your poem. You may also receive your poem as a PDF via email.
Would you like to be added to my mailing list? Mailings are infrequent and always lovely.
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Yes, please add me
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If you would like to suggest a subject for your poem, please do so here
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This is optional - I am happy to write a poem for you without any prompt!
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the information provided from this form will be used solely for the purposes of sending you a personal poem, unless otherwise specified or agreed to.
IF THE SPIRIT MOVES YOU, TIPS ARE GLADLY ACCEPTED HERE!
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VIRTUAL PERSONAL POETRY SESSIONS
