The Heart of Texas Chapter

of

Romance Writers of America

Membership Application and Renewal Form

Name: ________________________________________ Date: ________________________

Address: ____________________________________________________________________

City: ____________________________________ State: _________ Zip: _______________

Phone: ______________________________ Fax: __________________________________

National RWA Membership #: _______________ E-Mail Address: _____________________

URL Address: ________________________________________________________________

NOTE: You must be a member in good standing of Romance Writers of America� to join Heart of Texas RWA.

Name to appear on badge: _______________________________________________________

Published Romance Author _______ Published Other _______

Unpublished ________ Associate Member _______

General Membership dues are $18.00 (living within seventy-five mile radius of Waco). Out of State Membership - $15.00 Associate Membership - $15.00

Make checks payable to Heart of Texas RWA, and mail check with this form to: Lisa Buie-Collard / Treasurer, P.O. Box 20412, Waco, TX. 76702-0412.

What do you write? (Contemporary, Historical/Regency, Suspense, Time-Travel, ect.) ______________________________________________________________________________

Would you be interested in a volunteer position? YES_______ NO_______

Personal Profile (Optional) _______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

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