Name * First Name Last Name Email * Date of Birth * MM DD YYYY Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Institutional Affiliation (if applicable) Educational Status * Undergraduate Graduate Non-Traditional Will you be seeking academic credit? * Yes No Will you be interested in shared student dormitory housing? * Yes No Name of your most recent writing instructor (if applicable): The name of the writing instructor who has been most influential to you (if applicable): The title of the most recent book by the individual cited above (if applicable): Which payment category do you belong to? * $2,200 $1,800 if recommended by any past participant of the program $1,500 if recommended by anyone who has taught in the program $1,200 if you attended the PSP at any time in the past thirty years, or matriculate at a Michigan institution of higher learning other that Western Michigan University $800 if you are a matriculating graduate or undergraduate student of Western Michigan University 11,000 CZK if you are currently living in Czechia How did you hear about the Prague Summer Program? * Internet search Facebook ad Flyer Ad in Poets and Writers magazine A past PSP participant An instructor Other Please upload your manuscript (10 pages of prose or 5 pages of poetry): UPLOAD Thank you for submittig your application! You’ll hear from us in the following days.