Harriet Schock Songwriting Class Application

Name *

First

Last

Address *

City - State - Zip *

Phone *

Best Time to Reach You

E-mail *

What Do You Write?

How Long Have You Been Writing? *

Has Any of Your Work Been Published?

If Yes, please tell me a little about your published work, where it has appeared, who has performed your songs, etc.

Do You Play any Musical Instruments?

If Yes, which One(s)?

Do You Sing?

Do You Perform Your Own Work?

What Goals do You Hope to Achieve with this Course? *

Is there anything else you feel may help us work better together during the course?

I, the undersigned, will keep these assignments confidential. I understand that my tuition is nonrefundable. *

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