The Heart of Texas Chapter
of
Romance Writers of America
Membership Application and Renewal Form

Name: ________________________________________ Date: ________________________

Address: ____________________________________________________________________

City: ____________________________________ State: _________ Zip: _______________

Phone: ______________________________ Fax: __________________________________

National RWA Membership #: _______________ E-Mail Address: _____________________

URL Address: ________________________________________________________________

NOTE: You must be a member in good standing of Romance Writers of America® to join Heart of Texas RWA.

Name to appear on badge: _______________________________________________________

Published Romance Author _______ Published Other _______
Unpublished ________                      Associate Member _______

General Membership dues are $21.00 (living within a 75 mile radius of Waco).
Out of Town Membership - $15.00 (living outside a 75 mile radius of Waco).
Associate Membership - $15.00

Make checks payable to Heart of Texas RWA, and mail check with this form to: Yvonne Cypert, P.O. Box 20412, Waco, TX. 76702-0412.

What do you write? (Contemporary, Historical/Regency, Romantic Suspense, Time-Travel, ect.) ______________________________________________________________________________

Would you be interested in a volunteer position? YES_______ NO_______

Personal Profile (Optional) _______________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________