V/SB SCBWI Registration for 2011 Retreat - Print this form, fill it out and send it with your payment. Must be postmarked by November 19, 2010.
(Registration payment may be sent in advance of November to secure a place.)
Print clearly:
Name:
Street:
City:
State: Zip:
Email:
Telephone: (________)
Manuscript Title:
Manuscript Genre; Check One:
_____ Picture Book _____ Chapter Book / Easy Reader
_____ Middle Grade _____ Young Adult
Sub-Genre; Check One:
_____ Fiction _____ Historical Fiction
_____ Nonfiction _____ Poetry
_____ Fantasy/SciFi _____ Graphic Novel
DEADLINE - Postmark by November 19, 2010. Make check payable to V/SB SCBWI
Amount enclosed:
___$395 ___$435 ___$295 (Commuter)

Mail this registration form, manuscript and fee to:
V/SB SCBWI Retreat 2011
1001 Hillview Lane, Simi Valley, CA 93065

Questions? Contact Alexis at: AlexisinCA@aol.com
Visit www.scbwisocal.org to get the latest information
on events in the Ventura/Santa Barbara region.