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First Name: *

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Home Street Address: *

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Evening Telephone Number: *

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Application Type: *

Full-Time (24 hours) $800/half-year
Part-Time (6PM to 6AM on weekdays - all day on weekends) $600/half-year

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Reference 1

Name *

Phone: *

Email: *

Reference 2

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Phone: *

Email: *

Reference 3

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Phone: *

Email *

How did you hear about The Writers Room? *

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Description of Current Project(s): *

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By checking this box I agree to the following: *

If this application is approved, I understand that the privileges may be cancelled if the rules and regulations governing The Writers Room are not adhered to and, upon notice from The Room, I agree to forfeit my membership, keys or other evidence of admission.

I further agree not to hold The Writers Room responsible for loss of, or damage to, any books, notes, clothing, typewriters, computers, drafts, or other property belonging to me.

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