Last Name
*Email Address
*Phone:
*What genres do you work in (i.e., poetry, fantasy, personal essay, blog posts, etc)?
*How long have you been writing?
*How many pages (or poems) do you write weekly? (It's okay if the answer is zero. That will not disqualify you from working with me. Promise. Our goals is to get your writing!)
*In
one sentence, describe your current project, or the project you want to write.
Are you already published?
*If yes, please share links to your work.
*What do you want to be true for your writing life in the next 12 months?
*