ICT & Digital Media LA, LAVC, WC2 & GLAWS present
Digital Author + Self-Publishing Conference Banner
Attendee Registration Form
First Name:
Badge Name:
State (Abr):
Zip Code:
(required) E-mail:

Genres of Interest:

Thrillers, Suspense, Mysteries Science Fiction Romance (Classic/historical)
True Crime & Legal Drama Fantasy Romance (Fantasy/Paranormal)
Memoirs, Autobiographies Horror Young Adult & Children
True Crime & Legal Drama LGBT Self-Help, Spiritual
Mainstream & Realistic Fiction Poetry Self-Help, Physical
Nonfiction Current Chick Lit Religious, Spiritual
Historical FIction Erotic New Age
Drama (Screen, Television & Stage) Other:

Areas of Interest:
Fiction (novels and/or short story) Poetry, Lyrics
Nonfiction (current, historical, autobiographical) Other:
Screenplay (Motion Picture, TV, Stage)  

Level of Expertise:
Aspiring (you have the desire / interest in becoming a writer)
(you currently write and have works-in-progress)
(you are a published or self-author, paid writer, etc.)

Works Written: May be published traditionally, Indie,
or self-published.

How did you hear of this event?
Previous attendee, or...