01 December 2009
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This is the application form for Scotland Writes.

Once you have submitted the form you will be given a reference number and a link to have your completed form emailed to the address you enter on this page. Please print your email, with reference number, and post it to us with your script and a two-page summary of the series to complete the application process.

Please note that submitted forms without an accompanying script and a two-page summary of the series will not be considered.

This opportunity will only be open to those born or residing in Scotland

The closing date for entries is 5pm on Monday 2 November 2009.

Your Details

* fields are mandatory.

*First Name:

*Last Name:

*Address 1:

Address 2:

*City / Town:

County:

*Postcode:

*Contact Tel:

Mobile Tel:

Please ensure you enter your correct email address so that you can have your completed form sent to you, with your reference number.

* Email:

* Date of Birth:

Please note, you must be 18 years old or over on the closing date for entries, 1 July 2009.

*Age:

*Gender:

* Script name:

Tell us a bit about yourself. (what you like, what you've done, what you've written)

Monitoring Information

All monitoring information is confidential and collected for monitoring purposes only

Please select your ethnic origin

Do you have a disability?

If yes, please give details

How did you heard about this scheme?

If other please give details.

Can we contact you in the future to tell you about other related schemes either by email or post?

The BBC and its service providers will use the personal information you provide in the application form solely for the purpose of administering the Writersroom scheme. Please refer to the BBC's Privacy Policy if you wish to know more.

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