Creation Questionnaire

Name of person submitting*

First NameLast Name

Phone Number*

Please enter a valid phone number.Format: (000) 000-0000.

Email*

example@example.com

Name for the creation (Include nickname)*

First NameLast Name

Other please share

Addional "That's My Greatness" Poem ONLY Please add name Favorite color/s, hobbies, talents and dream goal for each additonal child.

Greatest gift, talent, attribute?*

What do you love or admire most about the person?*

Attitude or behavior that can improve?*

Hobbies, talents?*

Educations desires? (youth)

What do they want to be when they grow up? (Youth)

What is their dream? Are they living their dream or doing a combination?*

What is it everyone should know about the person?

Favorite color/s*

Anything else you want to share to go into the poem?

Pictures - (2- 10 pictures)(Quality of photos will determine quality on creation)*

My Products

8.5x11 Personalized "That's My Greatness"

$15.00 each for additional children. Designed in their favorite color

$25.00 Quantity

Personalized Name Poem

$25 per additonal child Designed in favorite colors w/pictures

$39.00 Quantity

11x17

$75.00 Quantity

16x22

$150.00 Quantity

20x30

$250.00 Quantity

Family Creation

16x22 A separate form must be completed for each family member

$150.00 Quantity

Personalized "We Honor Your Marriage"

8.5x11 Gold/Silver

$25.00 Quantity

Personalized "Tribute to Fathers"

8.5x11 Poem and Certificate of Appreciation (Please include family pictures, individual w/father and as a family)

$25.00 Quantity

Subtotal

$0.00

Tax

$0.00

Total

$0.00