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Write from Your Heart Waitlist Questionnaire
Interested in joining Umm Zakiyyah's private online writing retreat for women? Join our waitlist below:
* Indicates required question
Email
*
Record my email address with my response
Name
*
Your answer
Email
*
Your answer
Gender
*
Male
Female
Age Bracket
(Gregorian Calendar)
*
Under 18 (I understand I will need parent or guardian permission to participate)
18-29
30-39
40-49
50+
Location
(e.g. Texas, USA • Delhi, India • Lagos, Nigeria, etc.)
*
Your answer
WhatsApp
(or mobile) number
*
Your answer
Country Code
and Location for WhatsApp/mobile (e.g. +1 for USA)
*
Your answer
I am most interest in writing...
(Check all that apply)
*
children's books
fiction (e.g. novel writing, young adult fiction, etc.)
short stories
writing for personal healing
inspirational non-fiction (e.g. self-help, life lessons, spiritual growth, etc.)
memoir (i.e. true story/stories from your life)
Other:
Required
Best Days and Times for Me
(Check all that apply)
NOTE: Time zones below are based on EST and CST in the USA
*
Wednesday 6:30pm to 9:30pm EST (5:30pm to 8:30pm CST)
Thursday 10:00am to 1:00pm EST (9:00am to 12:00pm CST)
Thursday 12:00pm to 3:00pm EST (11:00am to 2:00pm CST)
Thursday 6:30pm to 9:30pm EST (5:30pm to 8:30pm CST)
Friday 6:30pm to 9:30pm EST (5:30pm to 8:30pm CST)
Saturday 12:00pm to 3:00pm EST (11:00am to 2:00pm CST)
Sunday 12:30pm to 3:30pm EST (11:30am to 2:30pm CST)
Other:
Required
Investment Level That I Prefer:
*
Payment Plan: 2 installments of $247.50 monthly ($495 total)
One-time Writer Investment of $450 (save $45)
VIP Payment Plan: 2 installments of $397.50 monthly (includes 1-on-1 private session with UZ)
One-time VIP Reservation Investment of $795 (includes 1-on-1 private session with UZ)
I'm not ready to invest in my writing (I understand this disqualifies me from the waitlist)
I want to join this online writing retreat because...
Your answer
Questions or Comments?
Your answer
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