EmailMe Form - PLAY SUBMISSION FORM

Your Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Primary Phone

### - ### - ####

Secondary Phone

### - ### - ####

Email

Website (if applicable)

Age

Do you identify as living with a disability?

Yes

No

Type/description of disability (optional - this will not affect consideration of your play)

Name of Play

Brief Description of Play (1-2 sentences)

If your play is selected, are you willing to discuss and make slight adjustments if necessary to accommodate time or space limitations?

Yes

No

Please upload your play in a Word or PDF document.