First Name
Last Name
Email Address
Phone:
What genres do you work in (i.e., poetry, fantasy, personal essay, blog posts, etc)?
How long have you been writing?
How many pages (or poems) do you write weekly? (It's okay if the answer is zero. That will not disqualify you from working with me. Promise. Our goal is to get you writing!)
In one sentence, describe your current project, or the project you want to write.
Are you already published?
If yes, please share links to your work.
What do you want to be true for your writing life and/or book in the next 12 months?