Participant Registration Form
Instructions: Fill this form out and check the appropriate boxes. When you register, please upload
this form as your submission, NOT YOUR MANUSCRIPT. Please do your best to fill this out as
completely as possible.
Personal Information
Name (last, first, middle)
Address (Street)
(Apt)
Primary Phone Number (xxx-xxx-xxxx)
(City, State)
(Zip Code)
Secondary Phone Number (xxx-xxx-xxxx)
Email Address
What is your genre?
 Fiction
 Poetry
 Creative Nonfiction
Please let us know your sub-genre
(i.e. fantasy, narrative, memoir, etc): __________________________________________
I am a: (You may check 2 boxes here. If you registered before March 23rd, you are an early
registrant. If you registered after March 23rd, you are a regular registrant. If you have attended
Boldface before, you will check 2 boxes.)
 Early-bird Registrant
 Regular Registrant
 Returning Participant
Affiliate Universities or Organizations
Education requirements: The Boldface Conference is currently offered to undergraduates,
college graduates, and independent writers without Masters Degrees in Creative Writing. If you
are currently pursuing or have received an MA, MFA, or a PhD in Creative Writing, then you may
not participate in Boldface.
Future MFAs/Mas: If you have been accepted to a Creative Writing program, but have not yet
begun attending classes, then you may still register for the Boldface Conference.
What best describes the highest level of education that you’ve completed?





High School Diploma or equivalent
Some college
Associate’s or Professional Degree
College Graduate
Graduate Degree (in a field other than Creative Writing)
Please indicate how many college-level workshops in creative writing you have attended.
Please also indicate their genre, instructors’ names and the university at which they were given.
It is not necessary to have attended any college-level workshops in order to attend Boldface. If
this is true for you, please write “none” in the field below.
Workshops attended:
Writing Sample
Please write or copy and paste a short writing sample into the following box. You can
manipulate your formatting as you wish. This writing sample will only be used to match you with
the workshop that will engage you the most. This sample is not the manuscript you will workshop
in the conference (or at least it doesn’t have to be). Your workshop leader will be in touch with
you to collect that manuscript in early May.
Medical Information
(This information will be kept absolutely confidential unless in the case of an emergency.)
Do you have any special physical needs or medical conditions that the staff
should be aware of?
 Yes (If yes, please indicate them: ______________________________________)
 No
Do you have need for special equipment or space?
 Yes (If yes, please indicate them: ______________________________________)
 No
Do you have any allergies?
 Yes (If yes, please list them: ____________________________________________)
 No
Emergency Contact Information
Name (last, first, middle)
Address (Street)
(Apt)
Primary Phone Number (xxx-xxx-xxxx)
Email Address
(City, State)
(Zip Code)
Secondary Phone Number (xxx-xxx-xxxx)
Housing Options
Housing is available for an additional fee at Cullen Oaks, the newly renovated
UH dorm. If you will need housing during the Boldface Conference, please
check the appropriate box below. (Note: Housing does not include meals.
However, the conference covers breakfast and lunch on-site Monday through
Friday. The cost for housing includes lines, a pillow, and a towel exchanged.
Check in date will be Sunday, May 22nd and checkout will be Saturday, May 28th
before noon.)
 Double (shared room), $235 for the entire week
 I do not need housing for Boldface
Individual Consultations
A limited number of consultations with visiting authors are available on a first
come, first serve basis. Boldface participants who sign up for individual
consultations will have the opportunity to have a one-on-one consultation
session with a working writer. Participants are limited to one consultation per
genre, but participants can choose any genre or multiple genres for
consultations. No more than 25 pages of prose, 10 pages of poetry. Each
consultation is $50.
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Fiction Consultation
Poetry Consultation
Creative Nonfiction Consultation
I do not require an individual consultation at this time.
Payment Information
Your registration will not be complete until you pay via the PayPal button on
www.boldfaceconference.com/register, or send a check or money order,
payable to Glass Mountain at the appropriate rate.
Boldface 2016 Rates
Date
Students
January 1, 2016 – March 22, 2016
$195
Community
Members
$295
March 23, 2016 – May 14, 2016
$295
$395
May 15, 2016 – May 23, 2016
$395
$495
Boldface Conference Rate: $_________________________________________________
Manuscript Consultation Total ($50 for each consultation): $____________________
Housing Total ($235 per room): $______________________________________________
Donations (we greatly appreciate it!): $_______________________________________
(Please include any additional fees, such as donations, housing, or individual consultations, in your total.)
Total: $___________________
If you prefer to write a check, please make them out to Glass Mountain with
“Boldface Registration” written on the memo line. Send them to:
Audrey Colombe
University of Houston
Department of English
205 Roy Cullen Building
Houston, TX 77004
Thanks for registering for Boldface! We’ll see you there!
BUT! Before you submit this form, we’d love your feedback! How did you hear
about us? Place a check next to the option that best applies below:
Online Ad __ Website __ Social Media __ Referral __ Class Visitor __
Glass Mountain Event __ Other (please specify): _______________________
Refund policy: We understand that sometimes unexpected events happen and plans change. In the event
that you are unable to attend the conference after registering, contact graduate advisor, Matthew
Salesses, with a refund request. We are able to provide refunds for registration fees, housing, and
consultations for requests made on or prior to May 1, 2016. After May 1, 2016, we will be unable to provide
refunds. A $25 processing fee will be applied to all refunds made.