Tell Your Story
A Year of Romance in 52 Steps

We're looking for terrific romantic ideas we can share with the book's readers.

• Elaborate or fancy
• Expensive or simple

Use as much space as you need. We want you to be specific. Give us all the details necessary so we can share your idea with others:

• What materials are needed?
• When is the best time for it?
• Where should it take place?
• Why is it romantic?

1. Tell us about something romantic you've done, that was done to you, or you'd find romantic if it were done for you by your partner.



Contact Information

2. Name:


3. Email (optional):


4. Phone Number (optional):


5. City (optional):


6. State (optional):



Demographic Information

7. Age:


8. Current Relationship Status:
• Married
• Dating
• Not currently in a relationship


9. If you are in a relationship, how long have you been in it?


10. How many children do you have children?
None
1
2
3
4
5
6
7
8
More than 8


11. If you have children, how old are they?


12. Occupation:


13. What else should we know about you?