7/25/2019 Writer Nominations for Future Residencies.rtf
1/3
Nomination Form
1) Your Information
Name: ________________________________________
IWP Program Afiliation: __________________________
Date: __________
Nominating or which program? ____________________
2) Candidates General Information
Name: ________________________________________
Country: _______________________________________
Age: ______ Gener: ______
Are!!: ______________________________
______________________________
______________________________
Phone: _______________________________
"mail: _______________________________
#o$%Proe!!ion: ________________________
Pre&iou! 'ra&el: ________________________
7/25/2019 Writer Nominations for Future Residencies.rtf
2/3
"ngli!h (anguage Pro)ciency: *"+cellent *Goo *Poor*None
3) Candidates Writing Career,plea!e )ll out a! $e!t a! you can-
Genre,!-: *)ction *poetry *play! *critici!m *tran!lation!*other ____________________________________
Nota$le Pu$lication! ,plea!e gi&e the "ngli!h title! an the genre oeach title-:
1)
2)
3)
4)
5)
'ran!lation! o wor. into other language! ,plea!e !tate the "ngli!htitle an the language! it ha! $een tran!late into-:
1)
2)
3)
4)
5)
Awar! an /onor!:
7/25/2019 Writer Nominations for Future Residencies.rtf
3/3
Comment!:
Top Related