NAME______________________________________________________________

ADDRESS___________________________________________________________

____________________________________________________________________

PHONE_________________________       E-MAIL_________________________

BIRTHDATE _____/_____/_____

PARENT/GUARDIAN________________________________________________

CURRENT SCHOOL_________________________________________________

SCHOOL ADDRESS__________________________________________________

__________________________________________________________________

GRADE AS OF 9/1/2001 _______ GENDER: F____ M____

RACE (optional) __________________ WORKSHOP ALUMNUS? Y____ N____

Indicate first choice of session with a "1" (& second choice if desired):

____ Session I (6/24 - 7/6) Open to new applicants and alumni entering grades 9-12 next fall who want to begin or continue in-depth study.

____ Session II (7/8 - 7/27) Open to committed writers entering grades 10, 11, 12, and first year of college who want to deepen their understanding and control of a specific genre.

Indicate a first (1) and second choice (2) of workshops (choices need not be based on extensive experience, but should include a commitment to in-depth study):

____ Song ____ Poetry ____Fiction

____ Playwriting ____ Magazine Journalism

Please indicate how you heard about the program:

____NY Times ____Wash Post ____Other ___________________________