KWA Membership Application

Kansas Writers Association

Mailing address: 9415 E. Harry St., Ste. 603, Wichita, KS 67207

Website: www.kwawriters.org

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

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

Membership Application

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. KWA will not release information without the member’s consent.

Check all that apply:

______ New Member     ______ Renewing Member     ______ Adult (over 18)     ______ Youth (Under 18)

Rates:

Adult (over 18)           $20/year

Youth (under 18)        Free

Contact Information:

___________________________________              __________________________________________

Name                                                                          Pseudonym(s)

___________________________________              __________________________________________

Address                                                                       Email

___________________________________              __________________________________________

City, State, ZIP Code                                                  Website

___________________________________              _________________________________________

Phone                                                                          Facebook/Twitter/Other

Biographical Statement – Publishing Credits:

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Writing Interest(s):

_____ Fiction     ­­­_____ Non-fiction     _____ Poetry     _____ Children’s     _____ Articles     _____Screenwriting     _____ Memoir     _____ Blogging     _____ Christian/Inspirational

Fiction Genre Interest(s):

­­­_____ Action/Adventure     _____ Family Saga     _____ Fantasy     _____ Historical     _____ Horror

_____ Mystery/Crime     _____ New Adult     _____ Paranormal/Ghost     _____ Police Procedural

_____ Romance     _____ Science Fiction     _____Speculative Fiction     _____ Suspense/Thriller

_____ Western     _____ Women’s fiction     _____ Young Adult

Non-Fiction Interest(s):

_____ Autobiography     _____ Biography     _____ Memoir     _____ Essay     _____ Cookbooks

_____ How-to Books     _____ Outdoor literature     _____ Travel literature

________________________ Other

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     _____ Facebook/Twitter

_____ Bio/Publishing history

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

­­­_____ Name     _____ Address     _____ Phone     _____ Email     _____ Website     _____ Facebook/Twitter

_____ Bio/Publishing history

_____ I that No Information is shared with Members or the Public.

_________________________________________              _________________________

Signature                                                                                 Date