25th Iligan National Writers Workshop

Application Form

Iligan National Writers Workshop

Instructions: Fill out all spaces and return this application form along with your manuscript and a
copy of it in CD (inside a suitable container) in MS Word format. Incomplete information and non-submis-
sion of photo will result in the rejection of your application. Please send by post or JRS, LBC, etc. all docu-
ments in one envelope postmarked not later than February 15, 2017. Emailed or faxed applications will not
be accepted. Please keep copies of your manuscripts because these will not be returned. Unpublished works
are preferred.

Last name First Name Middle Name

/ / Male
/ / Female

Permanent Mailing Address Office or School Address

Number and Street Number and Street

City/Province/Zip/Postal Code City/Province/Zip/Postal Code

Telephone/Email Address Telephone/Email Address

Date of Birth (month/day/year) Place of Birth (city, province, country)

Citizenship/Group or Tribal Affiliation Religion

Select your category/genre: Fiction: Short Story / / Novel: Work in progress / /

Poetry / / Drama / /

Language: / / English / / Filipino / / Tagalog / / Sebuano / / Hiligaynon

/ / Waray / / Chabacano / / other_______________

Education (course, year graduated/currently enrolled, school):

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Post-graduate

Graduate

Undergraduate

Certificate

Title(s) of works submitted with application.

(Optional) If submitted work has been published, or, if it has won an award, please provide infor-
mation.

Published works (list title and publication) – Use another sheet if necessary

Questions (Please answer on a separate sheet of paper if necessary):

1. Why I write

2. My writing plans

3. What the INWW fellowship would contribute to my writing plans

Recommenders: Please list two persons who can speak about you and your work. There is no need for
them to send us any letters of recommendation; we contact them if necessary.

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1. 2.

1. Name 1. Name

2. Number and Street 2. Number and Street

3. City, Province, Zip Code 3. City, Province, Zip Code

4. Telephone and Email Address 4. Telephone and Email Address

5. Relationship 5. Relationship

Certification of Original Work:

I, __________________________, of legal age, a Filipino citizen, residing in_______________

certify that the work I have submitted to the Iligan National Writers Workshop is original or it is not taken
or copied from any other work by any writer living or dead.

Signature

Residence Certificate number:

Witness: _______________________

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Mail all documents to:

Christine F. Godinez-Ortega
Director, 25th Iligan National Writers Workshop
Culture and Arts Studies Center
MSU- Iligan Institute of Technology, Iligan City
Tel. (063) 222-4500

If you have any questions or if you have any changes, amendments to your application, please call our
secretariat Mr. Miko Acebuche at (063) 222-4500 or the Project Coordinator Mr. Hermi Dico at 09177214697.