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RWA-SD MEMBER APPLICATION FORM
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* = REQUIRED NOTE: DO NOT USE THE RETURN KEY TO ADVANCE.
According to IRS requirements, dues are not deductible as a charitable expense, but may be deducted as a business expense.
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First Name *
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Last Name *
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| Pen Name |
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| Roster & Website |
Real Name Pen Name Real Name w/a Pen Name |
Date (mm/dd/yyyy) *
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Membership *
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New Member Renewal Associate |
Street Address *
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City *
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State *
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Zip Code *
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Phone *
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| Cell Phone |
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Email *
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| Fax |
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RWA National Status*
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Member Number
Applied Have Not Yet Applied |
RWA PAN Status *
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Yes
No
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RWA PRO Status *
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Yes
No
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How did you learn about us? *
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What is your writing background? *
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Are you published in Romance? *
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Yes
No
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Are you published in another Field or Genre?
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Yes Field
No
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| Special Interests |
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| Birthday(mm/dd) |
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| Comments |
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Newsletter by
Snail Mail * |
Yes
No |
Email Loop *
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Yes
No
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Payment Method *
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Check PayPal |
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