Inland Empire Chapter of Romance Writers of America

Membership Application Form

Inland Empire Chapter #63

Instructions:

You must first be a member of the national Romance Writers of America to join any local or online chapter of the organization.

Once you have your membership number in RWA, you may join IECRWA.

Instructions:

  1. Using the form below, fill in the appropriate information. Items in Red are required.
  2. Submit the form
  3. Use the Pay Pal button to remit your membership dues.
    Membership begins April 1.
    Dues will be pro-rated 50% ($12.50) for new members joining the chapter after October 1.
  4. If for whatever reason, your membership is not acknowledged, or if you have questions, please send an email to IECRWA Membership Committee

    Name:

    Address:

    City, State and Zip:

    Home Phone:

    Work Phone:

    Email:

    RWA Membership Number:

    Web Site URL:

    How Long Have You Been Writing:

    Are you Published?

    Yes
    No
    Publication Credits:

    Pseudonym?:

    What genres do you write? (Please check all that apply):

    Contemporary
    Historical   Time Period:

    Western USA
    European
    Medieval
    Regency
    Other Historical

    Fantasy
    Inspirational
    Futuristic
    Time Travel
    Paranormal

    Vampire
    Werewolf
    Shapeshifter
    Other Paranormal

    Erotica
    Suspense/Mystery
    Other

    If you checked other, please enlarge on your answer:

     

    How did you hear about IECRWA?:

     

    I fully understand the level of responsibility I have accepted with membership to IECRWA.

    I will faithfully adhere to the purpose and bylaws of the Inland Empire Chapter of RWA.

    Yes
    No
    Date of Application:

    Pay your membership dues now.

    When your payment is acknowledged, you'll be taken to our new member page.

    Welcome to IECRWA!

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