| Date |
|
|
|
| Name |
|
Age
(optional) |
|
| Address |
|
|
|
Phone
(Daytime) |
|
Phone
(Evening) |
|
| Fax |
|
E-mail |
|
| |
|
|
|
| What
genre of writing have you done? (fiction, nonfiction, essay,
poetry, short stories, novels, plays, etc.) |
|
|
| |
|
|
|
| Are
you currently working on a project? If so, what kind? |
|
|
| |
|
|
|
| What
things would be beneficial to you in a writer's group? |
|
|
| |
|
|
|
| Have
you ever had any of your work published? What, where,
and when? |
|
|
| |
|
|
|
| What
committee would you be interested in joining at WORD? |
|
|
|
Other
|
|
|
|
| |
|
|
|
| Do
you have any questions about WORD? |
|
|
| |
|
|
|
| Thank
you for your time and input. You will be hearing from
us soon. |
| TS
Murphy, Director |
| Writing
On Reality & Dreams |
|
|