We've detected that Javascript is not enabled. It is required for an optimal survey taking experience.
Please check your browser's settings and make sure Javascript is turned on. Learn how to enable Javascript.

Skip survey header

Autumn Poetry 2016

Thursday, October 20, 2016

5:30 - 7:30 PM

Warner Center Room 126

This registration form is for Autumn Poetry 2016 competitors only!
Non-competitors and audience members need not submit an application.
All competitors must have four poems (original is preferred, but not necessary).

There are two categories

Haiku style
sonnets and other forms.

All competitors must arrive by 5:00 PM in Warner Center Room 126 to check in on Thursday, October 20

Please enter your personal information below to register.

1. I am entering in the following category:

2. First Name:

3. Last Name:

4. Email address:

5. Phone Number (including area code):

6. College (Check one):

7. Year (Check one):

8. Briefly describe two interesting facts about yourself.

9. Home City:

10. Home state or country of origin:

11. Please submit a picture of yourself. Note that there is a one (1) megabyte file size limit!

File: {{filename}} delete