Local Authors Information Form Name (Last) * Name (First) * Pseudonym Birth Year (-Died Year) Birth City Birth State Current Location Buried Location Mailing Address - Street Mailing Address - City State Zip Code Phone (public) Enter your phone number here if you want the public to see it. Phone (private Enter your phone number here if you want it to be private. Email (public) Enter your email here if you want the public to see it. Email (private) Enter your email here if you want it to be private. Website Photo Files must be less than 2 MB.Allowed file types: gif jpg png. Occupation(s) Biography Please be brief and include your connection to the Pikes Peak region. Published Works Books, Articles, Pamphlets, Poetry, Screenplays. In addition to listing the titles, please include publisher name and publication date. Awards/Honors Education/Training Organizations Current membership in professional, civic, or social organizations. Interviews Please include links to any online video interviews. Speaker Availability Yes No Speaker Topics If 'yes', what subjects are you willing to speak about? Leave this field blank
Name (Last) * Name (First) * Pseudonym Birth Year (-Died Year) Birth City Birth State Current Location Buried Location Mailing Address - Street Mailing Address - City State Zip Code Phone (public) Enter your phone number here if you want the public to see it. Phone (private Enter your phone number here if you want it to be private. Email (public) Enter your email here if you want the public to see it. Email (private) Enter your email here if you want it to be private. Website Photo Files must be less than 2 MB.Allowed file types: gif jpg png. Occupation(s) Biography Please be brief and include your connection to the Pikes Peak region. Published Works Books, Articles, Pamphlets, Poetry, Screenplays. In addition to listing the titles, please include publisher name and publication date. Awards/Honors Education/Training Organizations Current membership in professional, civic, or social organizations. Interviews Please include links to any online video interviews. Speaker Availability Yes No Speaker Topics If 'yes', what subjects are you willing to speak about? Leave this field blank