Registration Form
for
"The Writer's Cocoon"
*NAME:
*ADDRESS:
*PHONE:
*DATE OF WORKSHOP:
*ARE YOU PUBLISHED?
HOW DID YOU HEAR ABOUT THIS WORKSHOP?
*WHAT DO YOU MOST HOPE TO GAIN FROM THIS WORKSHOP?
ADDITIONAL NOTES/COMMENTS:
*YOUR EMAIL ADDRESS?
YES
NO
Online
Email
Friend
Other