Name: _______________________________________________________ Address: __________________________________________________________ ____________________________________________________________ City: ___________________ State: ________ Zip Code: ________ Telephone: _______________________ E-mail: __________________ Which Seminar/workshop are you interested in applying for? ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Have you ever attended a writers’ workshop? ___ Yes ___ No. If yes, when and where: ____________________________________________________________ ____________________________________________________________ _____________________________________________________________ ___________________________________________________________ Will you be participating in the Workshop? If so, what are your expectations of this workshop? What do you hope to come away with? ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ Tell us briefly about yourself (work interests, hobbies, etc.): ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ___________________________________________________________ Do you want us to try to match you with a roommate? _____ Yes _____ No