North Carolina Writers' Network

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Online Registration
Squire Summer Writing Workshops 2017

July 13 - 16, 2017
Appalachian State University
Boone, NC 28608

This form requires you to pay by Visa, MasterCard, Discover, or Diners' Club. To pay by check, print and complete the form, and then mail it with your check to NC Writers' Network, Attn: SR17 registration, Box 21591, Winston-Salem, NC 27120-1591.

A limited amount of scholarship aid will be available for deserving writers. To apply for a scholarship, please send your current CV and a brief "statement of writing intent," describing your habits and goals as a writer, to ed@ncwriters.org no later than June 16.

* indicates a required field

First Name*

Last Name*

Address*

City*

State*

Zip*

County*

Email address*

Home Phone

(ext, note ...)

Office Phone

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Cell Phone

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Courses*

Your workshop manuscript must be sent the same day as your registration and deposit (please see Course Descriptions for manuscript requirements). Your registration cannot be processed until we receive and review your workshop manuscript.

Please indicate your choice:

Creative Nonfiction with Eric Wilson
Fiction with Sheryl Monks
Poetry with Joseph Bathanti


Costs*

Residency fees include all group meals from Friday breakfast to Sunday breakfast, attendance at the workshop sessions of your choice, and all evening programs and readings.

It's not too late to pay the member rate!

Add $75 to register me as a Member (Individual)
Add $55 to register me as a Member (Senior)
Add $55 to register me as a Member (Student)
Add $55 to register me as a Member (Disabled)
Add $130 to register me for a 2-year Individual membership
I am already a member, or do not wish to join or renew now

If you selected a Membership, please indicate your preferred format for receiving the NCWN Newsletter:

Printed copy mailed through US Postal Service
PDF format sent by email

Please indicate the cost that applies to you:

Yes, Please assign me a handicap-accessible room

Member, Shared Room ($575)
Member, Single Room ($675)
"Tag Along" rate ($175, meals, readings, evening programs only)
Member, Commuter ($425, group meals, workshop sessions, evening programs and readings)

Nonmember, Shared Room ($675)
Nonmember, Commuter ($575, group meals, workshop sessions, evening programs and readings)

Donation

Yes! I'd like to contribute toward Summer Residency scholarships. Here's my donation of...:
$5   $10   $15   $25   $50   (other amount)

Payment Today*

Please indicate your preference for today's payment:

$350 Deposit (balance due by Wednesday, June 28)
Full Payment


Gender*

Please indicate your gender to help us plan room assignments (if applicable):

Male
Female

Meals*

Please indicate your meal preference:

Regular
Vegetarian
Dietary Restrictions

Comment:


Refunds and Cancellations

Requests for refunds must be made in writing, and must be received by 12:00 p.m., Wednesday, June 28, in order to be refunded up to 50% of the total registration fee.

No refunds will be given for no-shows or requests made after June 28.