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Poets & Pints - Feature Survey
*
Indicates required field
Name
*
First
Last
Stage Name (if applicable)
*
Phone Number (not required)
*
City & State (abbv) of residence
*
How did you hear about our show originally?
*
Word of Mouth or Friend
Facebook
Cracked Walnut Website
Other
If Other please specify:
*
Email
*
Are you a person of color or an Indigenous Person? (we seek to have diversity, in every show, if we can)
*
Yes
No
What is your age? (must be over 21 for Poets & Pints)
*
21-28
28-35
36-50
50+
Gender or Preferred Pronoun
*
Female
Male
Other (please tell us in the box below)
Other (preferred pronoun)
*
WEBSITE? (Type "NONE" if none)
*
FACEBOOK? (Type "NONE" if none)
*
TWITTER? (Type "NONE" if none)
*
INSTAGRAM? (Type "NONE" if none)
*
YouTube Link of you performing (Type "NONE" if none)
*
YouTube Link of you performing (Type "NONE" if none)
*
Describe some themes covered in your writing?
*
Artist's Bio - Please write a little bio about yourself
*
What is the best way to contact you?
*
Facebook Messenger
Email
Phone
Other (fill in below)
Other (if applicable)
*
PLEASE ATTACH A PHOTO HEADSHOT HERE:
*
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Home
About
MEMBERSHIP
Email List Signup
Donate to CW
Contact Us
What's New
Newsletter
Workshops & Classes
Books
Literary Calendar of Events
Cracked Walnut Literary Festival