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Picture Book Clinic Form
Picture Book Mentoring Clinic Form
GPCWC 2021 Application
Picture Book Clinic
with Pam Halter & Kim Sponaugle
Application due no later than June 1.
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. What is the goal of your story?
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2. Do you want to try traditional or self-publishing?
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3. Are you an illustrator? (not required)
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4. Will you commit to the clinic process, including revising/rewriting and giving constructive feedback to other participants?
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To complete your application, you need to submit your manuscript (under 1,000 words).
Send as an attachment in MS Word or in RTF to Barb Haley
(haleybarb@yahoo.com).
In the subject line of your email put your name and GPCWC Picture Book Clinic.