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* 1. Your Name & Email Address

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* 2. Who is your Poem for?

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* 3. What is your relationship with them?

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* 4. For what occasion is this Poem?

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* 5. When and how did you meet?

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* 6. What feel would you like to give the Poem?

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* 7. What memories do you share with this person?

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* 8. Is there anything you would like me to make sure is included in the Poem?

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* 9. Any other useful information you can provide me?

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* 10. Any design specifications?

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