Dzanc Books/CNC DISQUIET International Literary Program in Lisbon, Portugal - June 30 - July 12, 2013

Home
About
- Who We Are
- Press
The Program
Contest / Scholarships
- 2011 Winner
- 2012 Winner
Alumni
Blog
Contact
Apply Now
- Second Payment
- Final Payment

Application

Now accepting applications for Disquiet 2013!

Please fill out the form below and attach a writing sample of up to ten pages along with your $150 deposit to secure your place in Lisbon next July!

Looking for contest or scholarship entry forms? They're over at our Submittable page.

Online Application

First Name: *

Last Name: *

Email: *

Gender: *

Female

Male

Program Affiliation:

Ohio Wesleyan University

The EKU Bluegrass Writer's Workshop

Stetson University

None of the above

Address where you can be reached through May 2013

Street Address: *

Street Address 2:

City: *

State / Province / Region: *

Zip / Postal Code:

Country: *

Home Phone: *

Work/School Phone:

Fax:

Date of Birth: *

Country of Citizenship: *

Workshop Selection: *

Fiction and Nonfiction with Robert Olmstead

Fiction with Tayari Jones

Fiction with Adam Levin

Poetry with Denise Duhamel

Writing the Luso Experience with Katherine Vaz

Acting for Writers with John Frey

The Fernando Pessoa Game with Terri Witek

Travel Writing with Philip Graham

(check all the workshops that you are interested in)

Housing: *

I will find my own housing for the duration of the program in Lisbon

I would like the ILP to help in arranging my housing

ILP Housing Preference (if applicable):

Hotel

Hostel

Dorm

Requested roommate:

Emergency Contact

Emergency Contact Name:

Street Address: *

Street Address 2:

City: *

State / Province / Region: *

Zip / Postal Code: *

Country: *

Phone Number: *

Email: *

Writing Sample:

Prepare a writing sample of no more than ten pages of prose or three poems. Save as .doc, .docx, .pdf or .rtf.

Notes & Special Requests:

Please enter here any notes or special requests you would like the staff of the ILP to take into account in considering your application.

Pay the $150 application deposit by clicking the button below. After you have received confirmation of payment from Paypal, please paste your PayPal receipt number or the entire confirmation email into the Paypal receipt field so we can confirm payment. Then hit the Submit button.

(Deposit is fully refundable in the event you are not admitted to the program, the program is cancelled, or you withdraw by the withdrawal deadline of March 15, 2013.)

To apply to the ILP Lisbon program by regular mail please send the following to the address below:
- a printout of the completed online application
- a writing sample of no more than ten pages of prose or three poems
- a check made out to “Dzanc Books” for the $150 application deposit.

Dzanc Books

ILP Application

50 Day Ave #2

Northampton, MA 01060

USA

You will be contacted within two weeks of receipt of your application.

Payment

Paypal Receipt:

Please paste your PayPal receipt number or the entire confirmation email so we can confirm payment