Online Writing Workshop Registration

Name*
First Last
Address*
Street Address City State ZIP Code
Email*
Have you been previously or currently involved with us? Check all that apply:
- Volunteer
- Donor
- Partner
- Prompt/HOTLIPS Pizza writing workshop participant
- Writing Workshop participant
- I'm new to you!
- Other
Other (fill in):
How did you hear about us?
Please choose the workshop you'd like to register for:*
Sliding scale fee $5-$50.*
Your workshop fee directly supports our free writing workshops in low-income housing communities, correctional facilities, hospitals, schools, treatment centers and other social service agencies.
Total
$0.00
Credit/Debit Card Information

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Confirmation*
- I confirm that I am over 18 years of age (if under 18, do not submit this form; contact our Program Director at sweller@writearound.org or call 503-796-9224).
*
- I have read and agree to the Registration, Cancellation, and Refund Policy.