2008 Membership Dues

 

 

Name _______________________________________________   RWA #_________________

 Address ______________________________________________________________________

 City __________________________________   State ______________ Zip _______________

 Home Phone __________________________________________________________________

 Alternate Phone _______________________________________________________________

 E-Mail ______________________________________________________________________

 Website: _____________________________________________________________________

 If Published, give Publisher Name(s) and Pseudonym(s):__________________________________

_____________________________________________________________________________

_____________________________________________________________________________  

  

  PAN Member _______________

 PRO Member _______________

 

 Fees enclosed:            NEW Member, $40                           _________

($20 Initial Processing Fee plus

$20 Annual Membership Fee)

                                                     - or -

$20 Renewal Membership Fee            _________

             Donation to Motivational Fund             _________

 

(Note: Former members must pay $40 to renew, if their membership has lapsed.)