KWA Membership Form

KANSAS WRITERS ASSOCIATION

9415 E Harry St, Ste 603

Wichita, KS 67207        www.kwawriters.org

 

Our mission is to inform, support, encourage, and promote the writer.

Membership Application

KWA will not release information without the member’s consent (Check all that apply)

I am a:       New Member        Renewing Member        Adult (18 years or older)        Youth (Under 18)

RATES:

  • $20/year for an adult (above 18) membership
  • Youth memberships (under 18) are FREE

 

                                                                                                                                                           

Name                                                                             Pseudonym(s)                                                                                   

                                                                                                                                                           

Address  line 1                                                                   Email

                                                                                                                                                           

Address line 2                                                                    Website

                                                                                                                                                           

Address City, State                                        Zip Code                          Twitter

                                                                                                                                                           

Phone                                                                                                                    Facebook/Other                                                                                                                                              

Biographical Statement / Publishing Credits                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   

 

 KWA maintains a Members-Only Roster.  Indicate what information, if any, you would like to make available to fellow members:            

 _____  Name      _____    Address      _____  Phone.    _____  Email 

_____  Website     _____  Bio/Publishing     ______  Twitter.    _____  Facebook

 

KWA maintains a Public website. Indicate what information, if any, you would like to make available to the Public.

_____   Name.    _____   Address.    _____ Phone     _____  Email

_____  Website.    _____ Bio/Publishing.    _____  Twitter.    _____  Facebook

 

If you prefer that NO INFORMATION is shared with Members or the Public, please check the box below.

_____ Do not share any of my information

 

                                                                                                                                                           

Signature                                                                                                        Date

 

Mail the completed application to the address above, along with your check or money order (no cash) made out to KWA, or apply at our monthly meetings.

The Kansas Writers Association is a not-for-profit, 501(c)(3) organization.