Dear Black Woman Anthology Form | DBW Digital Magazine

Dear Black Woman Anthology Interest Form

First name

Last name

Email

Phone

Multi-line address

Pays/Région

Adresse

Ville

Code Postal

How would you like your name to appear in the anthology? (Full legal name, pen name, or anonymous contribution.)

Are you comfortable sharing personal stories or experiences related to trauma, healing, or triumph?

Do you have any photos from childhood that you’d like to include in the book?

Have you previously written about personal experiences or contributed to any publications?

If "Yes" Please provide details.

Do you consider yourself a confident writer, or would you like support during the process?

Do you have any specific concerns about writing your story (e.g., emotional triggers, time constraints)?

Are you available to attend a photo session in your area if coordinated?

Yes

No

Maybe

If participating in a photo session, what days and times are generally best for you?

Are you comfortable being featured in promotional materials, such as social media posts, interviews, or videos?

Yes

No

Would you be interested in participating in the monologue play adaptation of the anthology?

If your story is selected for the monologue play, what key theme from your story do you feel would resonate most with an audience?

Would you be interested in attending the official book launch event in Atlanta, Georgia?

Would you like to participate in international events ?

Are you a poet, or do you have an interest in participating in a future Dear Black Woman poetry event or publication?

Would you like to contribute additional content, such as a poem or visual art, in addition to your letter?

If you answered "Yes" above, what would you like to contribute?

How frequently would you like to be updated about the anthology's progress?

Do you have any specific needs or accommodations (e.g., accessibility requirements, special considerations for emotional triggers)?

Are you interested in joining the Event Planning Committee for the Dear Black Woman anthology project?

Yes

No

Maybe

If yes, which aspects of event planning interest you? (Check all that apply)

Facilitating virtual events or online discussions.

Managing marketing and promotional activities.

Helping with international events or retreats.

Planning the monologue play adaptation.

Organizing local photoshoots.

Coordinating the book launch event in Atlanta.

Other

Do you have any special skills or resources to contribute to the committee?

If Are you willing to attend virtual planning meetings?

Yes

No

Do you have any additional suggestions for the Event Planning Committee or areas you’d like to help with?

I acknowledge that my submission:

Must be an original work created by me and not previously published elsewhere.
Will undergo an editing process for clarity, grammar, and adherence to anthology guidelines, while maintaining the integrity of my voice.

I understand that participating in this project involves a financial contribution to cover the following:

Publishing and printing fees.
Marketing and promotional efforts.
Individual photo sessions (if applicable).
Other project-related expenses.

I agree to make the payment by the specified deadline once my participation is confirmed. Failure to meet payment deadlines may result in withdrawal from the project.

If I participate in a photoshoot or submit personal photos:

I grant permission for these photos to be used in the book, promotional materials, and marketing campaigns.
I understand that submitted photos may be edited for quality or formatting purposes.
I retain the rights to my personal photos but agree to their use for this project.

I acknowledge that writing about personal experiences, including trauma, may evoke strong emotional reactions. I agree to seek support if needed and understand that the project team is not liable for emotional distress resulting from the writing process.

I may withdraw my submission at any time before the final draft deadline of May 16, 2025.
Withdrawal requests must be made in writing via email to kami@kamiredd.com
Any costs incurred prior to withdrawal are non-refundable.

I retain copyright ownership of my submitted work.
By contributing, I grant the anthology’s publishing team a non-exclusive license to publish, distribute, and promote my submission as part of this project.
My contribution may be adapted into a monologue play, promotional content, or similar formats, with proper credit given to me as the author.

I understand that participation in promotional activities, such as interviews or live events, is optional but encouraged.
If I agree to participate in the monologue play, I may be asked to sign a separate agreement for stage performances.

I agree to receive email updates and communications related to the anthology, including deadlines, promotional activities, and other relevant information.

Do you have a specific question or request regarding your participation in the anthology?