Kansas Authors Club - New Member Registration Form
Complete this form to become a member. Payment link follows form.
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Membership Type *
I am completing this form for updates to my membership record only.
Name (as you would like to be listed in the membership directory). Family Memberships Should list Surname Only here. *
For Family Memberships Only: List Names of individual family Members. (example: "Jane, John, Junior"
Mailing Address *
City *
State *
Zip Code *
Do you currently reside in Kansas *
County & District *
District affiliation is for dues distribution only, you may attend any district's meetings. If you are not a Kansas resident, please select your county of history or preferred affiliation.
Phone *
Email Address *
Website URL - Author Websites, Blogs, and Social Media pages (not personal pages) will be included in our yearbook and online member directory if provided.
Do you prefer a print copy of the annual yearbook publication or a PDF (sent via email)? Note that Junior Members and Members outside of the United States are only eligible for PDF copies of the yearbook. *
Required
Recommended By
(optional)
Kansas Authors Club has my permission to print my full name and address in the membership directory of the annual yearbook. *
If you answer no, only your name and city will be printed in the membership directory and annual yearbook.
Kansas Authors Club has my permission to print my email address in the membership directory of the annual yearbook. *
Kansas Authors Club has my permission to print my phone number in the membership directory of the annual yearbook. *
Areas in which you write (please check all that apply)
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