WILD WORDS - Sign-Up Sheet
Thank you for your interest in WILD's Poetry/Open Mic Night!

WILD is Wentworth's Womens Institute for Leadership and Development group and is trying to raise money to send our members to NCCWSL (National Conference for College Women Student Leaders). By participating you are helping us raise the money to provide this opportunity to many students at Wentworth.

Fill out the following information to register as a performer!

The event will be held at Pavement Coffeehouse on Commonwealth Ave (Boston University Campus)
736 Commonwealth Avenue, Boston, MA 02215

Time: 6PM on Wednesday, March 15th

There is a performance entrance fee of $3 per performer that will be much appreciated upon arrival.

Questions? Contact Seantel Trombly at tromblys@wit.edu

Full Name: *
If you are a part of a group, please list one person as a contact for the time being. We will reach out for names and contact information of all members shortly.
Your answer
Pronouns: *
Your answer
Email: *
Your answer
Phone number: *
Your answer
How many members in your group? *
(Limit 3)
Type of performance: *
Equipment needed:
Our supply is limited, so if needed, bring as much as you can that you may have of your own. What is listed is what we can provide.
Expected length of performance: *
This is to estimate when the cut off time is to work with our time frame provided.
Your answer
Time Constraints:
If other circumstances make you unable to attend the full event, please provide your preferred time frame in order to schedule performances correctly.
Your answer
Name of poem/song:
Your answer
Is this poem/song an original that you wrote? *
If you answered "no," please list the credited artist.
Your answer
Would you like to sell/give away items pertaining to your performance?
ex. CD's, shirts, stickers, cards, etc.
Your answer
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