#DearDiaryPDX
Diarist Submission Form
Email address *
First and last name: *
Your answer
What are your gender pronouns? (Check any that apply) *
Required
Email address: *
Your answer
Phone number:
Your answer
If you have any requests for accommodations based on disability or special needs, please outline them here. (You will have another chance to express this if booked!)
Your answer
Before proceeding to part 2, please familiarize yourself with the Diarist Info Sheet, found here: https://static1.squarespace.com/static/50fbe737e4b0dcfb3cb39367/t/5cafc252934b8800016dbb93/1555022421063/%23DearDiaryPDX+Diarist+Info+Sheet.pdf. If you are selected, I will be available to chat on the phone or in person about any questions. *
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