Online Writers Circles Waitlist
Name
First Name
Last Name
Email
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Phone Number
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Writing Circle Schedule: Please check the boxes next to the circle(s) you would like to be waitlisted for:
Sat. 10:00 -12:00 pm: 12/14, 12/28, 1/11, 1/25, 2/8, 2/22
Sun. 4:00 – 6:00 pm: 12/8, 12/22, 1/5, 1/19, 2/2, 2/16
Tues. 11:30 – 1:30pm: 12/10, 12/31, 1/14, 1/28, 2/11, 2/25
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 ________________.
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Image: Rather than photographs – let’s share an image that represents our inner selves when we’re feeling good.
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If accepted and able to attend, you will need to send $200.00 payment either through PayPal to donnajenson8@gmail.com (PayPal.me/donnajenson/200) 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/200)
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.
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