Scbwi Jane Yolen Mid-List Author Award
Form must be completed in full.
Name: Please use the name on your SCBWI membership)
Mailing Address:
Phone:
Email:
Have you ever received an SCBWI grant?
Which genres have you published in? (Bold as many as apply and add a category if needed)
Picture Book (Text / Illustration)
Board Book
Chapter Book
MG
YA
Novelty
Nonfiction
Poetry/Verse
When was your last book bought (not the publication date but contract date):
Publication History: Make sure to include publication year and publishing house. You may add additional
space if needed
In 500 words or less provide your career statement
(please include your career synopsis, awards and
accomplishments, and why the grant would be helpful at
this stage of your career).