MRW Membership Form 20-21
Email address *
First and Last Name (Legal Name) *
Town and State (Country if applicable) *
Phone Number *
Pen Name
PERSONAL FB page URL (not your AUTHOR group page) where we can friend you and then add you to our CLOSED MRW FB group
Check all that apply *
How would you like your meeting name tag to read?
Clear selection
May we share your contact information with the current MRW membership? (Check all that apply) *
What genres do you write? (Check all that apply) *
Membership new: $35 ($15 Jan-June) Renewal: $30
Membership dues run July 1, 2020-June 30, 2021. Membership renewals for 2022 will start in May 2021.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy