GPCWC 2017 Application

Application due no later than June 30

Date:	mm/dd/yyyy format
Title:
First Name:
Mid Init:
Last Name:
Address:
City:
State:	Select ** -- **Blank** AK -- Alaska AL -- Alabama AR -- Arkansas AZ -- Arizona CA -- California CO -- Colorado CT -- Connecticut DC -- District of Columbia DE -- Delaware FL -- Florida GA -- Georgia GU -- Guam HI -- Hawaii IA -- Iowa ID -- Idaho IL -- Illinois IN -- Indiana KS -- Kansas KY -- Kentucky LA -- Louisiana MA -- Massachusetts MD -- Maryland ME -- Maine MI -- Michigan MN -- Minnesota MO -- Missouri MS -- Mississippi MT -- Montana NC -- North Carolina ND -- North Dakota NE -- Nebraska NH -- New Hampshire NJ -- New Jersey NM -- New Mexico NV -- Nevada NY -- New York OH -- Ohio OK -- Oklahoma OR -- Oregon PA -- Pennsylvania PR -- Puerto Rico RI -- Rhode Island SC -- South Carolina SD -- South Dakota TN -- Tennessee TX -- Texas UT -- Utah VA -- Virginia VI -- Virgin Islands VT -- Vermont WA -- Washington WI -- Wisconsin WV -- West Virginia WY -- Wyoming
Zip:
Day Phone:
Night Phone:
Cell Phone:
Email:
Website:
Blog:
Working Title:

1. Have you had any books published yet? If so, list them, including the name of the publisher and the year published.

Characters Left

2. What do you want to write about? Be specific.

Characters Left

3. What have you done so far to develop your nonfiction book idea?

Characters Left

4. What do you hope to gain from this clinic?

Characters Left

To complete your application, you need to submit your first chapter (double-spaced) and a one-to-three-paragraph overview of your book, plus a descriptive table of contents (i.e., chapter titles with a single paragraph description under each title that briefly tells what that chapter will cover). Send as an attachment, saving your documents in ONE file in Word 2003-2007 or in RTF to Barb Haley (haleybarb@yahoo.com). In the subject line of your email put your name and GPCWC Nonfiction Book Clinic.