Your Name (required)

Your Email (required)

Your Address

City, State, Zip, Country

Your Phone

RETREAT INFORMATION

Date of Retreat

Retreat Location

PERSONAL INFORMATION

Writer Statement

Write by the Water is a retreat for writers from across the country, regardless of publication history. In order to assess our success in fulflling our commitment to diversity and to have a brief profle of new residents before they arrive, we ask applicants to provide the following information.

Date of Birth

Primary Occupation

Project summary: Briefy describe the project you wish to work on at Write by the Water (use only the space provided)

Professional achievements: Please list up to fve publications, awards, etc.

How did you hear about us?

Have you applied to Write by the Water before?
 Yes  No

If Yes to applied before, which year(s)

What else would you like us to know about you?
]

Genre(s):
 Academic/critical writing  Creative non-fction  Fiction  Non-fction  Screenwriting  Graphic novel  Playwriting  Songwriting  Memoir  Journalism  Poetry  Other (specify below)
Other:

While in residence, which genre would you primarily be working in?

IN LEIU OF SIGNATURE
I understand that I am responsible for all costs associated with travel to and from the location of retreat, dinner, and all personal expenses while participating in the Write by the Water Retreat. I understand that the Retreat fee, payable to Ricochet Enterprises, includes accommodations at Retreat (per above date / location), and some meals as stated. I release WBTW from any medical liability due to accident or injury and agree to be responsible for providing for my own medical personnel, first aid, first aid supplies and emergency transportation if necessary.
 I hereby acknowledge that I have read the above form and understand my obligations.