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LTAB U Indy Registration
Welcome to LTAB 2019!

The LTAB U Indy Registration is Step 1 of registering for LTAB. You will need Name, Date of Birth, Gender, Race/Ethnicity, Zip Code, Email Address, Phone Number, Social Media handles if applicable, and T-Shirt size.

One you've filled out this form, you'll receive an email confirming your Registration and outlining STEP 2 (PAYMENT). You can also find this information at youngchicagoauthors.org.

If you have any trouble with this form, please email Naihal Wajid at Naihal@youngchicagoauthors.org or call her at (773) 486-4331.

Poet First Name *
Your answer
Last Name *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Gender *
Race/Ethnicity *
Phone Number *
Your answer
Email Address *
Your answer
School *
Your answer
School/Poet City *
Your answer
School/Poet State *
Your answer
School/Poet Zip Code *
Your answer
How did you hear about LTAB? (ex. Past participant, from another poet, school poetry club) *
Your answer
Facebook Name
Your answer
Twitter Handle
Your answer
Instagram Handle
Your answer
T-Shirt Size (XS-XXXL) *
Your answer
Submit
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