Mail Only Application/Renewal Form
NOTICE: If you are mailing your membership application form to the address below please allow several weeks for processing.
You can contact our Membership Administrator with questions. Please allow us enough time to receive and process your application. Thanks!
LRWA Membership/Renewal Application
(Please print clearly)
Date: _________________
Name:
__________________________________________________________
Mailing Address:
__________________________________________________________
City:
__________________________________________________________
State/Province:
__________________________________________________________
Zip/PC:
__________________________________________________________
Country:
__________________________________________________________
Phone
(days): _______________________ (eves): ________________________
Fax:
__________________________________________________________
Email:
__________________________________________________________
Website:
__________________________________________________________
Select one:
○ New Member ○ Renewal
RWA® membership number (Required for LRWA membership):
__________________________________________________________
Pseudonym(s):
__________________________________________________________
I joined LRWA because: (Check all that apply)
○ No local chapters nearby.
○ Recommended by LRWA member.
○ I am interested in services provided.
○ Visited the web site.
Other:
__________________________________________________________
Referred by:
__________________________________________________________
Are you published? ○ Yes ○ No
Are you RWA PRO®? ○ Yes ○ No
○ Book-length Romance
○ Conventional or E-published/Audio
○ Novella or short-story romance
Other:
__________________________________________________________
Are you a member of PAN (RWA® Published Author’s Network) ○ Yes or ○ No
How long have you belonged to RWA®?
_________________ LRWA? ________________
LRWA is operated entirely by volunteers. As we add new programs and services, we need more people to help out. Would you be willing to add your name to our list of those who are willing to assist? ○ Yes ○ No
Sign me up!
My $30.00 membership fee for Lowcountry Romance Writers RWA is enclosed. (Check or money order in U. S. FUNDS ONLY.) There is a $35 charge for returned unpaid checks.
Dues and other amounts paid to the Lowcountry RWA Chapter are not deductible as a charitable contributions, but may qualify as business expenses.
Applications take 4-6 weeks to process. Thank you for your patience.
Signed:
__________________________________________________________
Date: _________________
Mail application form and check or money order made out to LRWA to:
Lowcountry RWA
c/o Carla Smith
P.O. Box 718
Summerville, SC 29484
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