Name
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First Name
Last Name
Email
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Birthdate (must be 20 or older, to apply)
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Month
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Day
Year
Date
Address
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Street Address
Street Address Line 2
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Mobile Phone Number
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Upload your 1,000 word essay on the topic “Why I Want to Write and Become an Author.”
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Upload a 20 page (minimum) sampling of your written work.
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