Poem Request Form

“Self Love” by Marlene Seven Bremner

“Self Love” by Marlene Seven Bremner

If you would like to request a personalized poem written by Marlene Seven Bremner, please fill out the form below.

Choose an amount that you would like to donate for the poem (suggested $5-$20 minimum), and then click submit. I will respond with a link to make your donation, and then I will type your poem on card stock using my vintage typewriter—currently an Olivetti Lettera 22.

Your Name *
Your Name
If you'd like the poem to be addressed to someone in particular, please put their name here.
Your topic can be anything that you can imagine. Please limit your overall topic to a few words. If you'd like a poem for or about someone in your life, for example your spouse, child, or significant pet, then please us the comment section below to elaborate and tell me a little bit about them. If you don't know what you want the topic to be, say "Poet's Choice," or ask me for more information.
Please use this space to elaborate on your topic. For example, if this is for someone special in your life, please tell me a little bit about them.
Please enter an amount you would like to donate for the poem (suggested minimum $20). I will send you a follow up email with a link to make the donation.
Address *
Address
Please enter the address where you would like the poem to be sent.
Addressee *
Addressee
Who's address is this?