I. Submission Guidelines

• All applicants must complete an application form and submit a writing sample of unpublished, original work of up to 20 pages (15 pages for poetry).
• Manuscripts must be in 12-point font, double-spaced, with the writer's name on each page. Pages must be numbered. Please include a brief synopsis if the work is an excerpt from a longer piece.
• Manuscripts cannot be returned.
• Submissions must be received by April 30, 2004. The deadline for scholarship consideration is March 31, 2004.
• An application fee of $20.00 must be mailed at the time of application to cover copying and reading costs.
• If applying for a scholarship, please include a statement of purpose of 500 words or less and one letter of recommendation attesting to the strength of your work and your level of commitment to it.
• If applying as an auditor, please include a detailed statement of purpose (250-500 words). Although auditors do not submit a writing sample for close consideration by members of the workshops, they participate in all other aspects of the program, as well as all ancillary conference events. The cost to audit is the same as full participation.
• If applying as a subscriber, please submit a 150-word statement detailing your expectations of the program. Subscribers attend all readings, lectures, and social events, but do not participate in the actual workshops.

II. General Information

Name:_________________________________________________________________

Address: _______________________________________________________________

______________________________________________________________________

City/State/Zip: ___________________________________________________________

Phone: ________________________________________________________________

Fax: __________________________________________________________________

E-mail: ________________________________________________________________

Date of Birth: ___________________________________________________________

Social Security Number: ___________________________________________________

 Please check one: 
___I am applying as a workshop contributor and have attached my writing sample.
___I am applying as an auditor and have attached a detailed statement of purpose.
___I am applying as a subscriber and have attached my brief statement of expectations.

III. Enrollment Status

Are you a matriculated Long Island University student? ___Yes  ___No 

Are you a matriculated Southampton Graduate Campus MFA in English and Writing student?
___Yes  ___No 

Are you a visiting student from another college or university? ___Yes  ___No 
(If yes, please tell us what school you currently attend:______________________________________)

IV. Workshop Registration

Contributors Only: Please indicate your first choice by placing a "1" next to your selection. In case your workshop is unavailable, you may indicate an alternate by placing a "2" next to your second choice. 
Auditors Only: Please number your workshop preferences from one to four, one indicating most preferred:

• ___Poetry with Billy Collins
• ___Playwriting with Christopher Durang
• ___Novel with Bharati Mukherjee
• ___Memoir with Frank McCourt
• ___Short Story with Clark Blaise
• ___Literary Essay with Roger Rosenblatt
• ___Poetry with Carol Muske Dukes
• ___Fiction with Melissa Bank and Matthew Klam

V. Scholarship Information

Scholarships are available to contributors only.

Please check one:
___I am not applying for a scholarship.
___I am applying for the Southampton Graduate Campus Writers Conference Scholarship. In addition to my writing sample, I have enclosed a letter of recommendation and statement of purpose.
 

VI. Manuscript/Statement Information

Title and genre of manuscript accompanying this form: __________________________

____________________________________________________________________ 

If manuscript is not submitted, please indicate type of statement enclosed:

____________________________________________________________________

If manuscript is an excerpt from a longer piece, please provide a brief synopsis here.  

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

VII. On-Campus Housing

Will you require on-campus housing? ___Yes ___No

Do you prefer:
___A roommate who does not smoke?
___To room with someone your own age?
___To room with an early-riser?
___To room with a "night owl"?
___To room with a friend? (Please indicate name here. Both parties must indicate their willingness to room with one another.)_____________________
___I would like to pay for a single room supplement ($500.00) if available. I understand space is limited. If no single rooms are available, I will be placed in the room lottery.

Do you need special housing for medical reasons? ___Yes ___No (If yes, please provide appropriate documentation.)

Would you prefer vegetarian meals during the conference? ___Yes ___No

VIII. Check List

Before signing and submitting this application, please check to see that you have the following.
__completed application
__writing sample or statement
__application fee
__recommendation letter (if needed)
__statement of purpose (if needed)
__medical documentation of special housing requirements

Signature:__________________________________________________________