AG00003_.gif (10348 bytes)Order Here

[ DaRomancer's House of Poetry ]


Welcome to the Order Page.   Please fill out all fields so that
we can handle your Order in a prompt fashion.  All fields that have
a ** next to them, are required fields.
There is a Special Information field if you can't find a place
any information you think we will require. 
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ALL INFORMATION PROVIDED ON THIS FORM
WILL BE KEPT CONFIDENTIAL.  WE DO NOT
SELL OUR EMAIL ADDRESSES NOR DO WE SELL
REAL PHYSICAL INFORMATION ABOUT OUR CUSOMERS.neoarule.gif (1971 bytes)

Order Form
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Pay By Electronic Check
Description of Items Price Quantity
Poem from Samples     
1 Things of the Heart
3 Things of the Heart
1 Love Letters            
3 Love Letters           
1 Romantic Ideas        
3 Romantic Ideas       
Fantasy One                
Fantasy Two                		1.00
7.95
19.95
7.95
7.95
7.95
19.95
7.95
7.95







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