Writer's Mentor Application Form

My Contact Info
(required info = *)

Addr. 2:
State:    Zip: -
*Phone/email - at least one *Best way to contact me is by
Day Phone: ext: Day phone
Evening Phone: ext: Evening phone
Email Address: Email

*I currently write . . .
(check as many as apply)
Short nonfiction pieces (magazine or newspaper)
Short Stories
*My current writing project is at the following stage . . .
Idea or broad concept
Rough outline
Detailed outline
Partial manuscript
Completed first draft
Other (please specify)
*Please describe your project in four sentences.
Name a few of your favorite books

*I am interested in . . .
Coaching (4 sessions per month, 4 months initial commitment).
Coaching Intensives.
Manuscript Evaluation.
*I am interested in coaching to help me . . .
(check as many as apply)
Start a new project.
Keep a current project on track.
Re-energize a project with support from another writing professional.
Work on my writing process to help make my writing time more effective.
Get high-quality creative feedback and support.
Identify "problems" with my work-in-progress and and then construct good, creative solutions to those "problems".
Increase and sustain my creative motivation over a longer project.
Create in the context of a supportive relationship that is professional, dependabel, and dedicated.
Develop early-stage strategies for getting my work published.
I use a . . . Mac PC Windows
Other (please specify)

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