Custom poem request form


To order your own custom poem, please complete and submit the form below. Once the form has been submitted, you will receive instructions for payment by Paypal, check or money order. If you prefer to complete the order form by hand and mail it with payment, a printable form can be found here.


For rush orders, longer or shorter custom pieces or orders of more than one poem,  please email for pricing and delivery timeframes before proceeding with your order.

Please note that your finished poem may be used as a sample on the Short-Order Verse website or in promotional materials for Short-Order Verse. In this event, any names included in the poem will be changed to protect your privacy.




Phone number (optional but recommended in case there are problems reaching you by email)


Please describe the occasion for which you’re requesting your poem, the honoree(s), if any, and the details you wish to have included. For poems concerning a specific person or persons, you may wish to mention details such as nicknames, likes/dislikes, inside jokes and anecdotes, trademark expressions, quirks, hobbies, accomplishments, family, occupation, age, and physical description. Remember to include the basics like name and hometown. Please provide as much information as you can -- the more detail you provide, the more flavorful your custom poem will be!


To prove you're not a robot, or are at least a reasonable please type "I am real" without the quotes in the following box: