Women's Center for Healing & Transformation Poetry Slam Sign up

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* 1. Name

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* 2. Email Address

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* 3. Phone Number (please include area code)

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* 4. Age Group

12 - 17

18 years of age or older

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* 5. Title of performance piece

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* 6. What is your performance piece about?

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* 7. Has your performance piece been previously published online or anywhere else?

Yes

No

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* 8. How did you hear about the Women's Center for Healing & Transformation's Poetry Slam?