Online Writers Circles Waitlist
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Writing Circle Schedule: Please check the boxes next to the circle(s) you would like to be waitlisted for:
Saturdays from 10:00 AM to 12:00 PM on Sept. 20, Oct. 4 & 18, Nov. 1, 15 & 29, Dec. 13 & 27, and Jan. 10.
Sundays from 12:30 PM to 2:30 PM on Sept. 21, Oct. 5 & 19, Nov. 2 & 16 & 30, Dec. 14 & 28, Jan. 11
Sundays from 4:00 PM to 6:00 PM on Sept. 21, Oct. 5 & 19, Nov. 2, 16 & 30, Dec. 14 & 28, and Jan. 11.
Mondays from 11:30 AM to 1:30 PM on Sept. 22, Oct. 6 & 20, Nov. 3 & 17, Dec. 1, 15 & 29, and Jan. 12.
Please submit a brief bio about yourself: Something like: I live in _____________. My favorite place to go is________________. For fun I ____________ and __________. My favorite self-care activity is ________________.
File Upload
Browse Files
Drag and drop files here
Choose a file
Image: Rather than photographs – let’s share an image that represents our inner selves when we’re feeling good.
Cancel
of
If accepted and able to attend, you will need to send $300.00 payment either through PayPal to donnajenson8@gmail.com (PayPal.me/donnajenson/300) or a check made out and mailed to Donna Jenson, 27 Laurel Hill Rd. Leverett, MA 01054. Please pay as Friends and Family if paying via PayPal!
I understand that if I am chosen from the waitlist and am able to participate in the writing circle I will be paying as Friends and Family via PayPal (PayPal.me/donnajenson/300)
I understand that if I am chosen from the waitlist and am able to participate in the writing circle I will mail a check made out and mailed to Donna Jenson, 27 Laurel Hill Rd. Leverett, MA 01054.
Please select any that might apply to you:
I am interested in donating to the Circle Scholarship Fund.
I would like to apply for a scholarship.
Submit
Should be Empty: