Scratch Writers Group Membership Application

Contact

First Name

Middle

Last Name

Street Address

Street Address 2

City

State

Email Address

Phone

Writer's Profile

I am interested in the

I am

An aspiring writer
A published writer
An accomplished Writer (1 book and/or 50 plus articles published)

Would you consider moderating a forum?

Yes
No
Possibly

Are you

Agented
Unagented

Primary Occupation

Expertise

Hobbies, Other Interests

Favorite Books

Favorite Writers

Favorite Movies

Favorite Bands

Writing Sample

Use our file chooser below to upload a writing sample. Your writing sample must be no less than 500 words and no more than, well, don't make it too long. There is a 10 MB limit on uploading your sample.

Writing sample

Writing sample :: Word docs or PDFs only!

Demographics

Demogrpahic data is for our information only. We simply would like to know something about our group as a whole, which perhaps could shape some features of this group (e.g., if we are all loaded, then we can meet on your yacht).

Are you male or female?

Male
Female

What is your age?

Highest level of education completed?

What is your yearly income?

What is your marital status?

Your political leanings?

Liberal
Moderately Liberal
Centrist, Moderate
Moderately Conservative
Conservative

Religious leanings

Atheist - There is no God
No, but each to his own
Yes, but not practicing
Yes, go to Church regularly
I am a God-fearing zealot

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