KRW Home Page
KYRW Membership Application
& Member Directory Information Form

Please complete this form*, print it and send it, along with your check or money order for $20 to:
Kentucky Romance Writers, Inc., 68 Sparrow Drive, Greensburg KY 42743

You may print this form and then fill it in or you may type in the information and then print the form. To fill it in on your computer use the tab key to move from field to field.

Name:

RWA#*:

Address:

City, State & Zip

Phone Number:

Fax Number:

Birthday (MM/DD)

Writing for

years

Pseudonym(s):

E-mail Address(es):

Personal Web Page Address:

Writing in the following Romance subgenre(s)--including Historical, Medieval, Long/Short Contemporary Category, Contemporary Mainstream, Mystery/Suspense, Paranormal, Fantasy, Futuristic, Inspirational, Time-Travel, Regency, or other (please name):

Romance-Writing Publishing Credits (attach a bibliography, if available)--include name of work, publisher, and publication date/year:

Other Publishing Credits (attach a bibliography, if available)--include name of work, publisher, and publication date/year:

Areas of Expertise (in which you could assist your fellow writers):


Thank you!

* To join KYR W. you must first be a member (in good standings of the Romance Writers of America (R WA). For an application, please write or call:

Romance Writers of America

16000 Stuebner Airline Rd., Ste 140,

Spring, TX 77379
Ph. (281) 440-6885
www.rwanational.org