Poetry Caravan Application (Please Print)
Date: __________
Name:
______________________________________
E Mail
address__________________________
Phone Number:s: Home __________________ Office __________________ Cell _____________________
Home Address:
____________________________________________________________________________
Genre of Primary Interest:
(check one):
( )Reading poetry of established
Poets ( )Reading own poetry
( )Combination of own/established
poets ( )Writing Workshop
Preferred venues (check as
many as applicable):
Nursing
homes ( ) Hospitals
( )
WomenÕs
Shelters ( ) Community
Centers ( )
Prisons ( ) Therapeutic
Communities ( )
Preferred times: (Circle all
applicable) Weekdays (a.m.) [p.m.]
Saturdays [late
a.m.] [early
p.m.]
Sundays [late
a.m.] [early
p.m.]
Comments:________________________________________________________________________________
Will you need
transportation? __________
Comments on other
requirements:______________________________________________________________
Why do you want to join the
Poetry Caravan? (Please write
several sentences)
Poetry Background: (can
include publication credits, performance history, awards, teaching background,
strengths); attach separate sheet if necessary: Please attach at least 3
sample poems.
Equipment Required: (i.e.
microphone, overhead projector, paper/pens) and comments:
Send this application and the poems to the Poetry
Caravan, care of:
Ruth D.
Handel: RuthHandel@verizon.net or 3
Gilmore Court, Scarsdale, NY 10583
or
Frank Sisco: ideasmoney@aolcom or
30Mill Road, New Rochelle, NY 10804