Name
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Name of person filling out the form
First Name
Last Name
Todays Date
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MM
DD
YYYY
What will the poem be used for?
A heartfelt Valentines Day Poem to remind your partner why you love them
Other
How did you hear about The Quickie?
Name of recipient
Name of the person you are giving the poem to
Relationship to
Relationship to the person you are giving the poem to
How long have you been with your partner?
Describe one thing about your partner that you love about your partner
When answering any questions, be specific and share meaningful details. For every question, include concise examples or moments that highlight your answers. For instance, if you love your partner’s humor, describe a joke or funny situation that made you laugh. The more specific and heartfelt your answers, the better we can capture your relationship in the poem.
Please choose exactly five questions to fill out.
Tell me more about a habit or quirk of theirs that you find endearing?
Share a specific memory with your partner that you never want to forget?
Highlight a specific moment when you realized how much you cared for them?
Explain your favorite adventure or experience you’ve shared together?
Mention a funny or sweet inside joke or moment that always makes you smile?
Describe how your partner makes you feel loved, appreciated, or safe?
Highlight a small, everyday moment with them that brings you joy, or something they do that makes your life better?
Share one thing they’ve taught you about love or life?
Tell me more about something you're excited to experience together in the future, or a dream you have for your relationship
If there's something important you'd like included in the poem that wasn't covered in the questions, feel free to share it below.
At The Wavy Poet, we take pleasure in infusing our poems with subtle touches of humor whenever it suits the context. Would you be comfortable with the inclusion of such elements of humor, provided they are relevant to the poem's theme or tone?
Yes
No
Are there any other tones/moods to this poem that you would like incorporated?
We enjoy showcasing these lovely poems on our social media platforms and website to promote our services. Are you comfortable with us using your name alongside the poem or would you prefer us to change the names if we decide to post it? Are you also comfortable with us tagging you on social media? Additionally, would you be open to collaborating on Instagram, where two users can share the same post together?
Please select all that apply:
Please change our names in the poem.
Please do not tag me on social media.
I would love to be tagged.
We don't mind, go ahead and post.
Terms And Agreement
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I agree to the terms and agreement