Name:_______________________________________________

Phone: _____________________________

Email:_________________________________________

Address:______________________________________________

Years spent writing: _______________________

Level of writing (i.e. beginner/experienced/published): _________________________________

Genre or field of interest ( Poetry: Fiction: romance, mystery, human drama. Nonfiction: biography, scientific, etc. ). _______________________

Writing goals – (Publication: what medium would you like to be published (i.e. books, newspapers, magazines)? Writing improvement? Pleasure? Seeking a publishing house or agent? __________________________________________________________

Professional writing organizations to which you belong: ______________________________________________

For which genre do you wish to form a critique group? ________________________________________

With what level of writer are you willing to work? _______________________________________

Have you ever been in a critique group or had a critique partner before? If yes, what were its benefits and strengths?

_________________________________________________________

_________________________________________________________

How often would you like to meet – once a week or once a month? _____________________________________________

What day and time would you like to meet (weekdays, weekends, day or evening)? ____________________________________

What are your expectations of the critique group experience? Why does it interest you?

__________________________________________________

Please complete this form and send to:
Midwest Writing Center
225 East 2nd St., Suite 303
Davenport, Iowa 52801

For further information on writing groups, Midwest Writing Center events and opportunities, consult our website at : www.midwestwritingcenter.org or call (563) 324-1410

The Center will attempt to match like-minded writers into categories of critique groups. Volunteers are welcome to help with this task. Please call if you’re intereste