ARNA BONTEMPS AFRICAN AMERICAN MUSEUM AND CULTURAL ARTS CENTER

JUNIOR WRITERS GUILD REGISTRATION FORM

DATE__________________

NAME ___________________________________________________

LAST FIRST MIDDLE

MAILING ADDRESS ________________________________________

CITY ______________________________ ZIP CODE _____________

PHONE # ________________________________________________

SCHOOL _________________________________________________

ENGLISH TEACHER _________________________________________

HOBBY(S) ________________________________________________

GRADE _____ AGE _____ BIRTHDATE __________________________

FAVORITE COLOR ___________________FAVORITE SNACK _______________

FAVORITE CANDY __________FAVORITE TYPE OF MUSIC ____________

FAVORITE SINGER _________FAVORITE MUSIC GROUP _____________

FAVORITE MOVIE_____________________________________________________

FAVORITE ACTOR_____________________________________________________

FAVORITE ACTRESS___________________________________________________

FAVORITE TV SHOW___________________________________________________

FAVORITE BOOK READ________________________________________________

EMAIL ADDRESS:_____________________________________________________