Application for Chapter Membership

Directions: Please print out and mail this form along with a check for $32.00 made out to SFA-RWA, to the Membership Officer (See address below). To become a member of the San Francisco Area chapter, you must be a Member in good standing with National RWA, or have concurrently applied for National Membership.

Name: _______________________________________________________________________

Name you want on your meeting nametag:________________________________________

Address: _____________________________________________________________________

City: ________________________________________State: ___________ ZIP: ___________

Home Telephone (____) ___________________ E-mail:_________________________________

This information is for membership use only.  It remains confidential and will not be given to agents, publishers, or press without the permission of the Member. You will receive chapter announcements and the chapter newsletter via the email address indicated above.

Areas of Interest

Historical/Regency Historical/Medieval Historical/Other Contemporary Mainstream
Young Adult Paranormal/Fantasy Screenplay Non Fiction Short Stories
Other (specify) _____________________________

Is there a subject you would like to see covered at future meetings or workshops?

_____________________________________________________________________

Writing Background

New to writing; no manuscript Finished manuscript; still in revision/targeting market
Actively shopping several manuscripts Newly published _____
Established Published Author Bestseller

Have you earned your Pro Pin? Yes No     If yes, what year? _____

Are you published in a non-romance genre? Yes No
If yes, state genre:_____________________________________________________________

If published in romance, please indicate publisher(s):

Romance Publisher:___________________________________________________________

Pseudonym(if applicable):_____________________________________________________

Other RWA Chapter Affiliations: Silicon Valley Sacramento Monterey Other ____________

Other Writing Group Affiliations: ___________________________________________________

Annual Chapter Membership Dues

Annual chapter dues are $30.00 plus a $2.00 one-time fee for processing.

Please provide the following information:

National RWA Membership No.:____________ OR Date of Application __________

A San Francisco Area Chapter Membership Card will be issued upon receipt of the National Membership number. Once you receive your National RWA Membership number, please notify the Membership Officer (see below) so your membership can be finalized.