NAME _______________________________________________ EMAIL_________________

HOME ADDRESS ______________________________________________________________________________

No. & Street ________________________________ ____ _________ PHONE ( )______________

City State Zip PARENT/GUARDIAN___________________________________________________________

CURRENT SCHOOL & SCHOOL ADDRESS________________________________________

______________________________________________________________________________

No. & Street ________________________________ ____ _________ CURRENT GRADE__________

City State Zip AGE ____ BIRTHDATE _____/_____/_____ SEX: _____F _____M RACE(optional)______

WORKSHOP ALUM? Y_____ N_____ If alum, specify year(s) you attended__________________

Indicate first choice of session with a “1” (& 2nd choice if desired):

_____ Session 1 (6.22-7.4) Open to new applicants and alumni entering grades 9-12 next fall who
want to begin or continue in-depth study.

_____ Session 2 (7.6-7.25) Open to committed writers entering grades 10, 11, 12, and first year of
college who want more in-depth study and increased control of a specific genre. Please indicate first (1) and second (2) choice of workshops (choices need not be based on
extensive experience, but should indicate a commitment to serious study):

___ Songwriting ____ Poetry _____ Fiction ____ Playwriting ____ Creative Nonfiction

Please indicate how you heard about the program:
___ Washington Post ____ NY Times ____ Internet ____Other:________________________________________