Cover request

Hello! Fill in this form with your book cover request and if it inspires me and/or I think I can do a good job on it then you will soon be a proud owner of a shiny new cover :)
The book title*
Your full name (to be on cover)*
Your gender

MaleFemale
Your age
Book genre*
Summary of your book (blurb)*
Any design preferences of how you'd like the cover to look?
Elements you want?*

Front coverBack coverSpineWrite the book too :P
Any preference to the size?
If left blank I'll choose a standard size
Any other links relating to your book?
NaNo username?
Any other info?
Your E-mail*
Please note: I obviously cannot make all the cover requests but will try to do as many as possible! I make no promises about completion or time frame. I'll be in touch before I start on your design. Other than that I look forward to designing some of your covers :)
Should be Empty:

Hello! Fill in this form with your book cover request and if it inspires me and/or I think I can do a good job on it then you will soon be a proud owner of a shiny new cover :)