Block Print Editor's Team Registration Form

Block Print Editor's Team Registration Form

Please fill out your details to register your interest in joining the Block Print Team. Meetings are held once per week May-August and November-February on a day of the week determined by the meeting members. Each term we select a theme we think is most interesting for that quarter of the year. What does our community need to discuss? We will then focus on writing exercises, peer reviewing, and exploring the world of literary publishing in a relaxed, beginner-friendly environment. All via Zoom! This is an all-ages group where all participants must feel safe and supported, any inappropriate responses or behavior after acceptance will result in immediate removal.
Participant's Full Name

First NameLast Name
Participant's Pronouns
Participant's Email
example@example.com
Participant's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant is under 18
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Full Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact's Relationship to Participant
Does the participant have any allergies, medical conditions, or special needs?
Please upload an example of your strongest piece of creative work (writing, art, poetry, essays, photography). This can be any form of creative art that you feel most represents your talents. This is optional, but gives us an idea of what your interests are!

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By checking the box below the participant consents to being photographed during the program. These photos may be used for social media posts or advertisements in the future.
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