membership :: New member registration


Welcome to Desert Rose RWA! We are thrilled to have you as a member. To join, please fill out the following fields. If you are paying by PayPal, you will be directed to a convenient payment page. If you prefer, you can fill out this form, print the page, and mail a copy of the completed form along with your check, made payable to Desert Rose Chapter 60 to:

New Membership
Desert Rose RWA®
PO Box 27407
Tempe, AZ 85285-7407

 

Important: If you choose to register online, your form will be submitted now, but your membership will be pending until your membership dues are received and your mandatory membership with Romance Writers of America® is confirmed through receipt of a National membership number.

 

personal information

 

Email:
First Name:
Last Name:
Pseudonym:
Address:
City/State/Zip:
Day Phone:
Evening Phone:
Fax Number:
Web Site URL:
Birthday (month & day):
Where did you hear about us? Do you have any comments?

 

Professional Information

 

Important Notice:

Membership with the National Romance Writers of America is mandatory. if you do not already have a national RWA® number, you will be required to become a member in order to join Desert Rose RWA®.
National RWA® Membership#:
Are you: PRO PAN

 

Tell us about your writing experience

 

Unpublished: (the next best thing just waiting to be discovered)
Published: Please check below.
  Published in novel-length Romance: (at least 40,000 words or 160 pages)
  Published in Other: (less than 40,000 words or 160 pages)

 

Category in which you write/are published (check all that apply)

 

Contemporary Historical Regency
Young Adult Romantic Suspense Inspirational
Erotic Romance Paranormal Other
If other, please describe:

 

Information Release Authorization

 

Important Notice:

May we publish your name, address, email and phone number in our Members Only Publications and Website?
No non-members will have access to this information.
Do Not Release Information
Show All Information First & Last Name
Day Phone Number Evening Phone Number
Street Address Email Address
Web Address Pseudonym

 

payment Information

 

Check one: I will pay my $30 dues via PayPal
I will pay my $30 dues by check. Indicate the check Information below:
Check Number:
Date Mailed:

Enter the text on the right: