- Yes - - No -    I will also participate as an Author Signing at 2011 Book Fair.

Legal Name:

Pen Name:

Badge Name:

Street Address:

Address (cont.):

City:

State/Province:

Zip/Postal Code:

Country:

Home Phone:

E-mail:

Your Choices

Friday Dinner

     Chicken Breast

     Pork Tenderloin

     Vegetarian Couscous

Saturday Afternoon Lunch

     King Salmon

     Butternut Squash Ravioli

     Herb Chicken

Sunday Afternoon Lunch

     Chicken Cobb Salad

     Caesar Salad

     Beef Thai Salad

My medical food allergies are:

Editor & Agent Selection

Please rank Editors and Agents in order of your preference (1-8). Please note, we cannot guarantee your first choice. All appointments are group appointments.

If you do not wish for an appointment with a specific editor or agent, please leave all selections as "0" for "not selected."

Editors

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Leah Hultenschmidt ~ Sourcebooks

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Angela James ~ Carina Press

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Tera Kleinfelter ~ Samhain Publishing

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Esi Sogah ~ Avon/Harper

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Junessa Viloria ~ Random House/Ballantine

Agents

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Melissa Jeglinski ~ The Knight Agency

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Jill Marsal ~ Marsal Lyon Literary Agency

- 0 - - 1 - - 2 - - 3 - - 4 - - 5 - - 6 - - 7 - - 8 -      Suzie Townsend ~ FinePrint Literary Management

About You

I am a workshop presenter for

I want to volunteer

I am tech savvy and want to help with workshops
No Yes

Preferred day to moderate No Preference Friday Saturday Sunday None

I want to moderate a specific session

This is my first Emerald City Writers' Conference. Please make me feel welcome.
No Yes

I accepted Cherry Adair's Write the Damn book! Challenge at last year's conference.
Not for 2011. Yay! I did it! I am almost there. Yikes! I did not finish!

How did you hear about ECWC?

    Chapter Member

     Internet

     Newspaper

     Radio

     Flyers

     RWR

     Library

     Other   

Registration Fees

GSRWA member - $269

Non-GSRWA member - $289

Not applicable - Special Guests (Keynote, Editor, Agent etc.)

Membership?

If you are an RWA member and would like to join GSRWA, please complete on our GSRWA Membership form before completing the conference registration form to receive the membership discount. (opens in a new window)

Add-On Bob Mayer Novel Writing Master Class

Master Class Add-On - $50

No Add-On at this time. (can be added later)

• Your Total Payment (U.S.)
• $

Payment Method:

     PayPal

     Check or Money Order

GSRWA reserves the right to substitute new speakers and to change the roster of events if necessary.

Remember to bring cash!
Please remember to bring additional cash for the raffle tickets! The Book Fair will have a (quicker) cash-only line as well. Remember, ticket sales help make the conference possible and a portion of the Book Fair proceeds go to DAWN.

Registration Dates & Deadlines:

• The hotel block rate expires at 5:00 pm on October 5, 2011.

Refunds and Return Check Policy:

• Refunds will be made, less a $25 processing fee, until September 30, 2011.
• Requests for refunds made between September 30, 2011 and October 12, 2011 will be made, less a $50 processing fee.
• Refunds after October 12, 2011 can be made for documented, serious medical reasons only (yourself or immediate family member), less a $50 processing fee.
• There is a $25 returned check fee.

E-mail ecwcregister@gmail.com with any questions or concerns.

If you have any other notes or comments, please fill in the box below:

Registration for the 2011 Emerald City Writers' Conference is not complete until payment is received in full. Editor and Agent appointments are added to the schedule when registration is completed. Please contact the Conference Chair for more information.