Intake form

Help us serve you better

Name *

Email address *

What themes resonate with you in poetry?

Please select at least one option.

Loss

Longing

Solitude

Melancholy

Hope

Love

How did you hear about MA WRITE'S?

What is your preferred style of poetry?

Would you like to share a personal story related to poetry?

Which service or services are you interested in?

Please select at least one option.

Poetry collection

Personalized poetry

Poetry workshops

Additional questions or comments

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