Basic Information

$35 Dues: (includes a $5 New Member Processing Fee).   Membership Dues are not deductible as a charitable expense but may be deducted as a Business expense.
Fee).

KOD Lapel Pin ($5 each)
Donation to Dues Assistance Fund
Amount Due

Name:
RWA® Membership Number:
Address:
City: State: Zip Code:
Phone: Fax:
E-mail Address:
URL:

Website Roster

May we list your name, homepage and e-mail on our website roster?
Yes
No
Or only the following information
May we list your city/state on our Website Roster?
Yes
No
Your writing level: (select one)
Beginner
Intermediate
Almost Published
Published
If published, please list titles of books, publishers, genre and publication date below:

If you use pseudonym(s) please list below:

Critique By Mail

Are you interested in a critique-by-mail service? Yes No

Special Interests

Do you have special interests or knowledge to share with members?
Yes No
If you answered yes to the above question, please list your special interests:

Would you write an article for the newsletter on them/it?
Yes No Maybe

Chapter Services

Would you be willing to serve as an officer of this chapter?
Yes No Maybe
If yes, do you have preference of office?
Would you like to volunteer to be on chapter committee?
Yes No Maybe
If yes, do you have preference for which committee?

Would you serve as a Contest Judge in a chapter Contest?
Yes    No   Maybe

Online Services

If you have online access, would you be interested in participating in the following:CLUES-N-NEWS our online discussion group
Yes No
LETHALADIES our online brainstorming, critique group
Yes No
INVISIBLE WORDS our online journaling group
Yes No

Your comments: