* * * R E G I S T R A T I O N  F O R M * * *

The 2nd National
APIA SPOKEN WORD & POETRY SUMMIT:
"first there was the word...then there was the FIST!"

AUGUST 1-4, 2003 // CHICAGO, IL
[Register early, as we are capping the summit at 175 people!]
Registration form. Please use block letters

Name_________________________________________________________ Age_____

Affiliation (if applicable)____________________________________________________

Organization_____________________________________________________________
Mailing
address________________________________________________________________

Phone (_____)_______________________Fax (_____)___________________________

E-mail__________________________________________________________________

* * *
YOUR SUMMIT STAY:
Please fill out as much as possible, so we can arrange transportation & accomodations.
*If you require homestay due to financial hardship, you must email jona@mangotribe.com
with your request by July 1, 2003.

Will you be traveling alone? ___yes ___no

If no, how many?_____ Flying? _____ Driving? _____

Arrival Date:________________________________________________
(include approximate time of day)

Departure Date:_____________________________________________
(include approximate time of day)

Will you require housing for entire length? ___yes ___no

____Yes, I am a Youth (under 21)
____Yes, I will be participating in Youth Session on Friday, August 1st.
*** Youth under 18 years of age must turn in signed waiver form with registration!

____Yes, I will be staying for NPS 2003
____Yes, I am on an NPS slam team (which one?:_______________________)

NOTE: Once your registration is confirmed, we will request your flight information

Tentative Schedule (*Optional Activities):
Thursday, July 31: Suggested arrival for Youth
Friday, August 1 (starting 9am): Youth Session & Registration for Adults
Saturday, August 2 (morning) - Monday, August 4 (late afternoon): Summit Activities
*Monday, August 4 (evening): I Was Born With Two Tongues Homecoming Show
*Tuesday, August 5: Chicago Tourist Day

* * *

GETTING TO KNOW YOU:

What's your medium?______________________________________________________________

Do you prefer the stage or the page?______________________________________________________

How long have you been writing? _____________________

How long have you been performing? __________________

Any allergies? (e.g. cats) __________________________________________________

Any special requirements we should know about?
______________________________________________________________________

______________________________________________________________________

Dietary concerns (e.g. vegetarian)
_____________________________________________________________

How did you first hear about this summit?
_______________________________________________________

What do you hope to gain from this summit?
______________________________________________________________________

______________________________________________________________________

Last mind blowing play/book/concert/cd/event/person you experienced?
______________________________________________________________________

______________________________________________________________________

_____ Yes, I would like to perform in summit showcase (Ind: 3-5 min / Group: 7-10min)
(We must receive this info by July 25th in order to secure your performance time!!!)
*** Please fill in or attach bio (75 words or less), title (if applicable) & description of performance
______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

REGISTRATION CHECK LIST:

___ Completed Registration Form

___ Completed Waiver Form (for Youth under 18) - download waiver at www.wordfist.org

___ Requested Registration Donation ($15 Youth under 21 / $20 Adults)

___ Official T-shirt purchase payment ($12 advance price) - design by Chamindika Wanduragala
Circle Size: Youth M L / Adult M L XL XXL
*see www.wordfist.org for design*

Please return this registration form via snail or email (jona@mangotribe.com or jona@2tongues.com)
before July 31, 2003 (NO WALK-UPS WILL BE ACCEPTED ON AUGUST 1ST).

*If you are sending your form via email, please mail your checks separately
and include a copy of your registration form for reference.

Please make checks payable to:
ASIAN AMERICAN ARTISTS COLLECTIVE
(Please write in "Memo: APIA Summit 2003/your name")

APIA Summit 2003
c/o Asian American Artists Collective
3105 N. Ashland Ave #293
Chicago, IL 60657