Full Week Experience Registration Form | Antioch Writers Workshop

Please Note: Young Writers requires a separate process for registering. Please see the Young Writers page for details.

IMPORTANT: Registration fee ($125.00) is due upon registration; registrations/selections are not held or confirmed until registration is paid.

Download a printable Full Week Registration form - To pay by check, you must print and mail this form.

To register and pay online, please fill out the form below:

Required fields *

First Name: *

Last Name: *

Email Address: *

Phone Number: *

Cell or alternate contact number: *

(in case of emergency during workshop week)

Address: *

City: *

State: *

Zip Code: *

Which Contact Information would you like included in our participant information packet during the workshop week?: *

Email Address

Phone Number

Address

None of the above

Please click here to agree to our terms of agreement to continue your registration: *

I agree to the terms of agreement

Media Release: I hereby release use of my image and/or my Evening Reading for use in promotional materials, including but not limited to the AWW Web Site, Blog, Facebook page, YouTube, email newsletter, and Yellow Springs Public Access TV

I understand that the $125.00 Registration Fee is NONREFUNDABLE.

I understand that Tuition is due by June 13, 2012; after that date, a late fee of $50.00 will be added.

I understand that if I cancel between June 14-30, 2012, 50% of the Tuition Fee is NONREFUNDABLE. All cancellations must be sent to the workshop Director IN WRITING.

I understand that if I can after June 30, 2012, 100% of the Tuition Fee is NONREFUNDABLE. All cancellations must be sent to the workshop Director IN WRITING.

Please Select ONE of the following Afternoon Seminars: *

Fiction with Crystal Wilkinson--THIS SEMINAR IS FULL; PLEASE SELECT ANOTHER SEMINAR OR EMAIL DIRECTOR AT info@antiochwritersworkshop.com TO BE ADDED TO WAIT LIST. Manuscript of up to 20 double spaced pages required.

Fiction with Linda Gerber--THIS SEMINAR IS FULL; PLEASE SELECT ANOTHER SEMINAR OR EMAIL DIRECTOR AT info@antiochwritersworkshop.com TO BE ADDED TO WAIT LIST.manuscript of up to 20 double spaced pages required.

Fiction with Carrie Bebris--manuscript of up to 20 double spaced pages required.

Fiction with Les Edgerton--manuscript of up to 20 double spaced pages required.

Focus on Form with Chet Kelly Robinson (this is the only afternoon seminar that does NOT require a manuscript).

Poetry with Jim Daniels--THIS SEMINAR IS FULL. PLEASE SELECT ANOTHER OPTION. Manuscript of up to 10 pages of poetry required.

Creative Nonfiction and/or Memoir with Sandi Wisenberg--THIS SEMINAR IS FULL. PLEASE SELECT ANOTHER OPTION. Manuscript of up to 20 double spaced pages required.

Your Tuition Rate (select only ONE)

You will receive an invoice for Tuition and Add-Ons between March 7-June , 2012. ALL Tuition and Add-On Fees are due by June 13, 2012. (Late fee of $50.00 will be invoiced after June 13.)

Selected Rate: *

Ohio college, university or community college CURRENT student or faculty member. (To receive this rate, you must provide proof of enrollment/employment—photocopy or scan of CURRENT ID—by Tuition due date of June 9.) TUITION IS $450.00

AWW Alumni Rate. TUITION IS $550.00

Local Resident Rate. TUITION IS $550.00

Non-local/First Time Attendee Rate. TUITION IS $610.00

Years Attended:

Which OHIO county (check ONE):

Add-Ons

Do you wish to attend the Saturday Seminar, 8:00 a.m.-4:00 p.m. July 7, 2012 (Full Week Workshop starts 6:00 p.m., July 7, 2012)?: *

Yes. THIS ADD ON IS $75.00

Do you wish to have a one-on-one manuscript consultation with one of our AWW faculty members? : *

Yes. THIS ADD ON IS $85.00

Select up to three (using numbers 1, 2, 3, in order of your preference)

Please note, selections are filled on FIRST COME, FIRST SERVED basis. LIMIT ONE MANUSCRIPT CONSULTATION PER PARTICIPANT.

Morning Fiction Instructor:

Morning Poetry Instructor:

Morning Creative Nonfiction Instructor:

Afternoon Fiction Instructor--Carrie Bebris:

Afternoon Fiction Instructor--Crystal Wilkinson:

Afternoon Fiction Instructor--Les Edgerton:

Afternoon Fiction Instructor--Linda Gerber:

Afternoon Focus on Form Instructor :

Afternoon Poetry Instructor :

Afternoon Memoir/Personal Essay Instructor :

Please click Submit and Continue to submit your selections and pay the $125 registration fee for the Full Week Program. Please note: your registration and selections are not held or confirmed until registration is paid.