Name ______________________________________

Address ____________________________________

E-mail _________________@___________________

City/State/Zip ________________________________

Phone _____________________________________

MEMBER PROFILE

How many years have you been a member of SCBWI? _____________________
How often have you attended Illinois SCBWI programs?

___often ___sometimes ___seldom ____never

Please order your interests:

Picture Book ___ Easy-to-Read ___ Chapter Book ___ Educational ___
Middle Grade ___ Young Adult ___ Non-fiction ___ Poetry ___
Magazine ___ Illustration ___ Adult ___ Other ___

Do you have another career besides writing / illustrating? ____ If so, what? ___________________________________

Do you submit to publishing houses on a regular basis? Yes / No
Have you been published as a children's writer/illustrator? Yes / No

CRITIQUE GROUPS

Are you currently a member of a critique group? Yes / No
Would you be interested in either ___ joining a group or ____ being part of a new group?

Please check all answers below that you would find acceptable in a critique group.
(*Star any answers for which you have a strong preference)

Manuscripts

___ read aloud ___ read silently ___ read prior to meeting

Critiques

___ verbal critique ___ written critique ___ standard critique form

Would you like there to be a limit to the number of mss critiqued at each meeting? Yes / No

Time

Meeting time: ___ Daytime ___ Evening ___ Weekends
Frequency: ___ Weekly ___ Monthly ___ Bi-monthly
Length of meeting: ___ 1-2 hours ___ 2-3 hours ___ 3-4 hours

Meeting location: ___ rotate houses ___ regular meeting place

How far are you willing to drive? ____________

Would you like members of your group to share newsletters or writing publications? Yes / No
Would you like your group to devote time each meeting for discussing current market news? Yes / No
Would you plan to attend meetings on ____a regular basis or ___only when you had work to share?

Do you have any suggestions or comments on critique groups?