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:

Using the form below, fill in the appropriate information. Items in Red are required.

Submit the form

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.

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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