MFA Faculty and Visiting Writer Residency Information Please submit this form by Friday, May 27, 2016. First Name * Last Name * Email * Marketing and Publicity The Ashland University MFA Program will publicize the summer residency events through press releases, brochures, website promotion, and newsletters. During the residency, the IT department will be filming craft seminars and evening readings for posting on the University website, and the Marketing department may request time for an interview with you. Please indicate whether you are willing to be recorded as part of your visit to campus, and also whether you consent to speaking with members of the press or members of the Marketing department at Ashland. Marketing and Publicity * Yes, I am willing to have my craft seminar and/or evening reading recorded to be posted to the Ashland University website following my visit. Yes, I give my consent to be interviewed by any members of the press or members of the Ashland University marketing department. No, I do not grant permission for the IT department to video tape my sessions during the summer residency. No, I do not consent to interviews with the press or with members of the AU marketing department. Meals Lunch and dinner are provided by on-campus dining services and catering at Ashland University during your stay. Please indicate and dietary restrictions or allergies we should be aware of. Upon arriving for dinner, please alert the staff to your dietary needs. Dietary Restrictions Dairy-Free Gluten-Free Vegan Vegetarian Food Allergies list below Allergies Emergency Contact Information Please provide the name and phone number of a contact in case of an emergency. First and Last Name * Phone Number * Alternate Phone Number * Travel Information In addition to the honorarium, lodging, and meals while on-campus, Ashland University will reimburse you for all of the following: Taxi fare to/from airport Mileage ($0.40 per mile) to/from Ashland, plus tolls (if driving, maximum travel reimbursement is $400) Parking fees at airport Airfare (please consult with Cassy Brown prior to purchasing your flight if it exceeds $400) We regret that we are unable to reimburse travel expenses in advance of the residency. In order to be reimbursed, please keep all receipts and flight invoices and remit these no later than August 15 following the residency. Travel Arrangements * Driving Flying Are you driving or flying?