Kindling Words East Registration

Personal Details

This information will be included in the bio book so you are able to communicate with your new and old friends after the weekend. The Bio Book is printed and shared as a PDF. It is against Kindling Words policy for anyone to use this info for anything other than personal connections. It is never allowed to be shared beyond our group.

Name*

First Last

Name Pronunciation*

Please write out your name phonetically

Preferred Pronouns*

she/her

he/him

they/them

additional/other pronouns

Additional/other pronouns

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

Website

Strand*

Check all that apply

Author

Illustrator

Editor

Types of books you create(or would like to!)

Please check all that apply for your writing, illustrating or editing work.

Picture Books

Early Readers

Chapter Books

Middle Grade

Young Adult

Adult

Graphic Novels

Novelty books

Fiction

Non-Fiction

Will this be your first Kindling Words East?*

Yes! It's my first time attending

No - I've attended before

Bio*

Short bio - 100 words or less.

Headshot for Bio*

The photo is so that we can match names to faces. Please submit a recent photo that is recognizably YOU (use a photo of your face with no pets, kids, or props getting in the way). Headshots for the Bio Book must be 300 DPI and at least 1.5 inches wide. Thanks!

Accepted file types: jpg, jpeg, png, Max. file size: 4 MB.

Title of one of your books to be featured*

Publisher & year of publication*

About the food*

We would like a rough count for the vegetarian main dish.

I will eat only vegetarian meals

I will likely choose from both vegetarian and meat / fish choices

I will not be eating the vegetarian main dish

Any food restrictions or allergies?

We will share this information with the conference center, but please be sure to confirm with hotel staff with upon arrival.

Accomodations*

We are hoping that most of our attendees will stay at Hotel Providence, as we've got the whole place to ourselves, and we need to fill all 80 rooms. Also, the more that people split rooms (there are 24 rooms that have at least 2 beds), the more people we can let in off of our waitlist. Please let us know whether you are planning to stay:

In a single room at Hotel Providence

In a double room at Hotel Providence

Other

Double room info

If you know your roommate's name, please write it here. If you do not yet have a roommate but would like to connect with a potential one, please write "I'll connect on the spreadsheet"

Slide Images

Please upload additional photos as below for the intro slideshow. The images should be no less than 75 DPI, but a greater DPI would be better. We want to make the clearest presentation of your life and work.

Photo 1 - Image of your book*

This should be one image with the cover of one or more of your books. (If you are a debut creator and you don't yet have a cover image, you may submit an image of title, publisher & pub year of a book under contract). Please title the file "YOURFULLNAME_book"

Accepted file types: jpeg, jpg, png, Max. file size: 4 MB.

Photo 2 - Your family/loved ones*

Human or otherwise! Please title the file "YOURFULLNAME_family"

Accepted file types: jpeg, jpg, png, Max. file size: 4 MB.

Photo 3 - Fun photo of you*

An image of you doing something fun! Please name the file "YOURFULLNAME_fun"

Accepted file types: jpeg, jpg, png, Max. file size: 4 MB.

Payment

Kindling Words East Cost*

$595 tuition/retreat fee (only refundable through 12/15/23). Please book your hotel room directly with Hotel Providence.

Price:

Scholarship Fund Donation

In this business, fortunes fluctuate. If you are having a stronger year, please consider making a donation to the scholarship fund so that another person in a different stage might be able to attend.

Activation Code

Please enter your activation code if you received one. It's not required - if you don't have one, just hit submit below.

Total

This is the amount that will be sent to Paypal when you click the "submit" button below. If you prefer to pay by check, or if you would like to request an installment plan, please contact us at kwe@kindlingwords.org before submitting this form.

Comments

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