2011
Name: RWA® Membership Number: Address: City: State: Zip Code: Phone: Fax: E-mail Address: Loop E-mail (if different in Yahoo groups) : URL:
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:
Are you interested in a critique-by-mail service? Yes No
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
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
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