Nebraska Romance Writers  APPLICATION FOR MEMBERSHIP

Name: ___________________________________________ Date: _____________________
Street Address: ______________________________________________________________
City: ______________________________ State:____________ Zip: _________
Phone: Day (___) _________________ Evening: (___) ____________________
Email: ___________________________________________________

RWA® National Membership Number: _______________________

You must be a member of Romance Writers of America® National and in good standing to be eligible to join the Nebraska Romance Writers Chapter.

Pending RWA® National Membership:
If you are in the process of joining of RWA® National,
when did you apply? Date: ______________________________

If you are just joining RWA® National now, the RWA® National Application and Dues must be sent directly to RWA® National. Obtain form at www.rwanational.org.

Please indicate if you are  Published     Published/Not Romance     Unpublished
Publisher(s): ________________________________________________________

Optional Information for Nebraska Romance Writers Chapter:

Birthday (month/day): ______________________________________

I am interested in joining (or forming) a critique group    Yes     No
I am currently active in a critique group     Yes     No

My areas of expertise and/or hobbies include the following (and I am willing to be contacted to share my knowledge): __________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

Dues:  Annual Membership Fee is $20.00. If you join after July 1^st the Membership Fee is $10.00.  Make checks payable to: Nebraska Romance Writers.

Please send check or money order with Membership Application to:

If you have any questions, please contact Lucy Lien, Director of Membership.
Phone: (402) 327-2510    Email: membership@nebraskaromancewriters.com