Please fill out this membership application. You may submit it online or print it out and send check or money order.

  1. Please provide the following contact information:

    Name
    Title
    Organization
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Country
    Work Phone
    Home Phone
    FAX
    E-mail
    URL

  2. Please identify and describe yourself:

    Age

  3. Select any of the following options that apply:

    Reporter           Nonfiction writer  Fiction writer     Poet             
Editor             Graphic designer   Painter            Photographer     
Ceramicist         Other
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Last modified: 03/05/04