City of Cupertino, CA | Poet Laureate Application

*Full Name

*Residential Address

*Daytime Phone

Evening Phone

*Cupertino Resident / Employer

Resident

Employee

*Email

Employer (if applicable)

*Cupertino Address

Please check one for each of the following:

I will be at least 18 years old and a high school graduate by August 2025

Yes

No

I am an active poet and have been published or been publicly recognized for my contributions to poetry

Yes

No

I am the sole creator of the attached poems

Yes

No

I have strong, demonstrable ties to the City of Cupertino

Yes

No

I am comfortable speaking in public. If speech impaired, I may delegate reading tasks to qualified speaker

Yes

No

I am comfortable teaching community workshops and leading collaborative community partner events

Yes

No

If you answered “no” to any of the above questions, you are not eligible to be appointed Cupertino Poet Laureate.

*Three-to-five original poems (published or unpublished)

Choose file (Poem 1)

Choose file (Poem 2)

Choose file (Poem 3)

Choose file (Poem 4)

Choose file (Poem 5)

(Provide atleast three poems)

*Current Resume

Choose file (Resume)

*Two Letters of Recommendation or References

Choose file (Reference 1)

Choose file (Reference 2)