Residency Application Form

This application form is for people who wish to become a resident at the House for the first time. The residency fee is waived for the first month. (If you are a returning resident, you can enroll in a residency without applying again.)

Name *

First

Last

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email *

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

How did you hear about the House's residency program? *

Your website (if available)

What's your top choice of residency dates? *

If your top choice is full, which of the following choices will you consider? *

January 6-31, 2020
February 3-28, 2020
March 2-27, 2020
April 6 - May 1, 2020
May 4 - May 29, 2020
June 1 - June 26, 2020
July 6 - July 31, 2020
August 3 - August 28, 2020
Sep 7 - Oct 2, 2020
Oct 5 - Oct 30, 2020
Nov 2 - Nov 27, 2020

Are you seeking full time or part time residency during your first residency? *

Full time
Part time

Please consult the FAQ for the distinction.

Are you seeking one-time residency or repeat residencies (if your first one goes well)? *

Your Project *

Briefly describe what you want to accomplish during your month-long residency

What schedule do you plan to keep at the House? (See FAQ for our opening hours) *

Briefly list the days and hours you plan to be here. You are not required to stick to this 100%, but we encourage a consistent schedule so that when your muse is here, you are too.

Your writing sample (pdf, doc, or docx) *

Up to 10 pages representative of your writing. If your creative field is in something else, please provide information and examples of your work in the question below.

Anything else you want us to know?

Phone

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Los Angeles Writers' House