Membership Application

Membership Form
Questions marked by * are required. Please complete the form electronically or print and mail to Dunes & Dreams RWA, C/O Candace Goldapper, Treasurer, 207 Sixth Avenue, Holtsville, NY 11742.
1. I agree to the terms of membership in Dunes & Dreams RWA *
  • Yes
  • No
2. Applying for: *
  • General Membership
  • Associate Membership
3. Name: *
4. Pseudonym
5. Email: *
6. Address *
7. Phone Number
8. RWA Number *
9. PAN Member
  • Yes
  • No
10. PRO Member
  • Yes
  • No
11. Published in romantic fiction
  • Yes
  • No
12. Website Address
13. How did you hear about Dunes & Dreams RWA?
14. Interested in Volunteering?
  • Board
  • Events
  • Programs
  • Newsletter
  • Other
15. Making Payment by *
  • Check by mail
  • Cash at the next meeting
 
© 2009 - 2010 Dunes & Dreams Romance Writers - Where Romance is a Shore Thing!