Bread Loaf Workshop Leader & Directory Form
Dear Bread Loafers,

Please submit this form so we can assign you to a workshop.  After we receive the ranked list from each participant, we will use that information to assign the workshop leaders.  We will send notification regarding workshops leaders on July 7. When choosing names, please be sure to scroll down through the full list of twenty faculty names.

We also ask that you provide us with the correct information for the Bread Loaf directory which will be distributed to all participants of the conference.

And, if you have any food allergies, please note them here as well so that we can share them with the Bread Loaf kitchen staff.

We will have a photographer on campus. Please let us know if we have permission to use your photo in promotional materials.

Lastly, please enter your emergency contact information and whether or not you will have a car on campus.

Thank you,

Noreen Cargill and Jason Lamb

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Email *
For Office Use Only
First Name *
Middle Name
Last Name *
Street Address or PO Box *
City *
State *
Zip Code *
Country
Phone Number (with area code) *
Gender Pronoun
Please note your age at the time of the conference.
Genre in Which You Will Be Attending *
Workshop Leader Request
If you were invited in fiction or poetry, please list four choices for a workshop leader in order of preference; if you were invited in nonfiction, list three nonfiction faculty in order of preference (for your fourth choice, choose "I am attending in nonfiction"). For more information on the faculty workshop leaders, see the list of faculty bios on the Faculty & Guests page of the Bread Loaf Writers' Conference web site. Please note that special guests do not lead workshops.
First Choice *
Second Choice *
Third Choice *
Fourth Choice *
Directory
Please include only the information that you would like included in Bread Loaf directory which will be distributed to all conference participants.
First Name *
Last Name *
Street Address or PO Box
City
State
Zip Code
Country
Phone Number (with area code)
Email
Web Site (if you have one)
Social Media Handle
Meals
Food Allergies
Bread Loaf can accommodate vegetarian, vegan, and gluten-free diets. Please list here only the foods for which you have a severe allergy--if there is more than one item, please separate each food name by a semi-colon. We'll forward the information to Chef Darren Zeno so he is aware of it.
Vehicle
Will You Have a Car on Campus *
License Plate
If you will have a car on campus, please list your license plate number here.
Photos
Photo Permission *
Photos taken during the conference may be used for publicity purposes. Will you allow Bread Loaf to use photos of you in future Bread Loaf Conferences materials?
Emergency Contact
Name *
Relationship to You *
Phone Number (with area code) *
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