Application form

Name *

First

Last

Email *

Phone number *

Address *

Date of birth (dd/mm/yyyy) *

Occupation *

Brief personal bio – who are you? *

What type of writing do you do? *

Please tell us about your previous writing experience, publications, education, etc. *

Briefly describe what you'd like to accomplish on your retreat *

I am applying for: *

1-week residency with private bath ($1,185)
1-week residency with shared bath ($975)
2-week residency with private bath ($1,830)
2-week residency with shared bath ($1,495)
1-month residency with private bath ($2,980)
1-month residency with shared bath ($2,675)
Other (specify below)

When would you like to come? We are currently taking applications for July 1-31, 2024 (Your retreat can last anywhere from 7 to 30 days. If less than 30 days, you can can begin at the beginning or middle of the month. Please indicate whether your dates are firm or flexible.) *

How do you feel about [usually well-behaved, chill] dogs? *

If I had my life to live over again, I’d rescue/adopt every dog in need
Yup, dogs are great
They’re okay if they don’t jump
Meh, I don’t particularly like them, but they don’t bother me
Nope, don’t like dogs, especially big ones
I’m terrified of dogs
I’m allergic to dogs

Special dietary requests/food allergies/sensitivities *

Do you have any special needs or requests?

Is there anything else you'd like to say that didn't fit logically in this form?

Discount code

Website

Once you have submitted your application, please send a 2-page writing sample in the body of an email to casamismac@gmail.com with the subject: [Name] – Writing Sample

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