Please fill out this form to the best of your ability, keeping your intentions and vision in mind. Every detail helps craft a personalized creation that aligns with your desires, emotions, or the message you wish to convey. If you’re unsure about certain sections, don’t worry! I'll work closely with you to refine your vision.  

General Information

Name: _________________________________  Email & Phone: ___________________________________

Shipping Address: __________________________________________________________________________

Preferred Contact Method: ☐ Email ☐ Text ☐ Other: _____________________________________

Receiver's (if applicable): _________________________ Relationship: ___________________________

Birthday or Zodiac Sign: ____________________ Reason for Gift: ____________________________

Type of Creation

Personalized Keepsake Frames

(Includes: a personal photo or painting, up to 4 types of foliage, one creature embellishment, a personalized haiku, and an artist’s choice detail. Refer to the Patron’s Tribute page for price tiers.)

☐4x6 – $ ______ ☐5x7 – $ ______ ☐8x11 – $ ______ ☐12x18 – $ ______ ☐18x24 – $ ______ 

Resin Art Pieces

(Includes a base design with chosen colorants, intention setting, and one embellishment.)

☐Sets – $ ______ ☐Tiny Molds – $ ______ ☐Small Molds – $ ______ ☐Med. Molds – $ ______ 

☐Large Molds – $ ______ ☐Custom:__________________

Intention Pieces

Purpose of the Piece (select all that apply): ☐Happiness ☐Protection ☐Love ☐Healing ☐Gratitude

 ☐Psychic ☐Wealth ☐Luck ☐Other: ____________________________________________________________

Intention Symbols, Herbs, Crystals, or Embellishments to Include: ______________________

______________________________________________________________________________________________

Personal Energy or Message You'd Like to Imbue into the Piece:_________________________

______________________________________________________________________________________________
 

Premium Collection

(Includes rare pigments, luminous effects, premium embellishments, and layered artistry.)

☐Exclusive Frame – $ ________ ☐High-End Resin Piece – $ _______ 

☐Luxury-Themed Custom Set – $ _______ ☐Other: _________________

Commissioned Artwork

(Fully bespoke experience with deep artistic collaboration.)

☐Painting or Mixed Media – $ ______ ☐Special Themed Resin Art – $ ______ 

☐Unique Keepsake – $ ______

Preferences & Choices

Design & Theme

Preferred Color or Color Palette: _________________________________________________________

Opaque or Translucent Pigment (or both)? _________________________________________________

Preferred Theme (celestial, forest, gothic, ethereal): __________________________________________

Favorite Symbols or Motifs (moons, stars, butterflies): ______________________________________

Level of Sparkle: ☐None ☐Subtle Shimmer ☐Bold Glitter ☐Other: _____________________________

Do you prefer a minimalistic or intricate design? ☐Minimalistic ☐Intricate ☐Medium

Vision & Story

Briefly describe your vision for this keepsake: ___________________________________________

______________________________________________________________________________________________

Is there a story, emotion, intention memory, symbols or sentiment you’d like this piece

to convey?__________________________________________________________________________________

Additional Notes or Requests: _____________________________________________________________

______________________________________________________________________________________________
 

Floral & Foliage Elements

(Up to 4 types included, additional selections below.)

Favorite Preferred Foliage: ☐Natural (Dried) ☐Artificial ☐Both

Favorite Plants: ____________________________________________________________________________

Favorite Flowers: __________________________________________________________________________

☐Surprise me! (Artist’s Choice)

☐Extra florals/foliage (+$15): ______________________________________________________________

☐Special request florals (rare/sentimental) (+$25+): ________________________________________

Other Floral/Foliage Preferences: ________________________________________________________

Embellishments

(Each piece includes one. Select extras below.)

Any preferred embellishments (lace, pearls, metallic accents)? _______________________________

Favorite Animal: ☐Butterfly ☐Moth ☐Beetle ☐Raven ☐Owl ☐Fox ☐Bat  ☐Other _______________

Favorite Mythical Creatures: ______________________________________________________________

Favorite Crystals/Rocks/Gems/Minerals: _________________________________________________

☐Mystical Elements (Fairies, dragons, celestial bodies, runes, sigils) (+$25): ___________________

☐Additional creature embellishments (+$10–$25 per extra): _______________________________

Other Embellishments:_____________________________________________________________________

Poetry & Inscription

☐Standard Haiku (Included) ☐Extended Haiku (24 lines) (+$20) 

☐Full Personalized Poem (No haiku limit) (+$50) ☐Custom Inscription (+$25) 

Other Poetry/Inscription Requests: _________________________

Special Theme Add-Ons 

(+$35 per theme)

☐Gothic Elegance (dark)☐Celestial Magic (cosmic)☐ Nature’s Whisper (earthy) ☐ Whimsical Fauna (light) ☐ Alchemy & Arcana (symbolism) ☐Other: ________________________

Display Enhancements

☐Ornate Frame (Vintage, Gothic, etc.) (+$40) ☐ Gold/Silver/Bronze Leaf Detailing (+$30)
☐ Hand-Painted Frame Accents (Florals, celestial, mystical designs) (+$50)
☐ Shadowbox Frame (Dimensional enclosed look) (+$60)
☐ Custom Resin Display Base (For freestanding pieces) (+$45)

Other Frame/Resin Display Enhancements: _______________________________________________

Special Keepsake Additions

☐Mini Glass Vial (Pressed flowers or ashes) (+$30)
☐ Tiny Scroll with Handwritten Message (Aged parchment effect) (+$25)
☐ Embedded Gemstone or Crystal (Amethyst, Quartz, Obsidian, etc.) (+$35)
☐ Hidden Pocket Charm (Secret compartment for wishes or memories) (+$40)

Other Keepsake Additions: ________________________________________________________________

Practical Information

Review

Budget: $ ___________ Review Draft: ☐Yes ☐No Desired Deadline: ____________ 

Gift-wrapping ☐ No ☐ Yes... if yes, please specify: ____________________________________________

Any other questions or concerns? _________________________________________________________

______________________________________________________________________________________________

Confirmation

☐ I confirm that all the information provided in this form is accurate. I understand that my custom order will be created based on these details, and any changes requested after approval may result in additional charges and extended processing time.

☐ I acknowledge that I have read, understood, and agree to the Whimsy & Wards Policies regarding custom orders, payment, shipping, refunds, and product care. I understand that all sales are final.

Customer Name (Print): _______________________________

Customer Signature: _________________________________

Date: _______________________

Once completed, please submit this form along with any reference photos (if applicable) to elizabethpoje@whimsywards.com OR whimsywardsllc@gmail.com. Any personal materials will need to be shipped by the patron. You will receive an invoice and estimated completion time within 24-48 hours.

Thank you for helping craft a meaningful, one-of-a-kind treasure! I look forward to bringing your vision to life!