Membership Application
Please print clearly and fill out all pages of the application. Return the application and you check for yearly dues of $12 to the Membership Chair (address below). If you are joining after the beginning of the year then figure $1 for each remaining month of the year as your total check amount. (i.e., If you join in June, then your check should be made out for $6 – $1 @ month.)
Date __________________ ACRA# ______________
Name _______________________________________________________RWA# _____________
Email: _____________________________Pseudonym (if applicable) _______________________
Street _________________________ City and state____________________ Zip_______________
Phone #s – Home____________________ Work__________________(ext. _____) Cell_____________________ Fax ____________________ Website:_______________________
RWA Chapters you have in the past or currently hold membership in: ______________________________________________________________________________
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Offices you have held in those chapters (Check all applicable):
____President
____Vice President
____Secretary
____Treasurer
____Membership Chair
____Committee Chair(s) Please list____________________________________________
________________________________________________________________________
Chapter Committees you’d be interested in serving on:
____Hospitality
____Awards
____Education
____Workshop
____PRO/PAN _________
____Publicity
____Moneymaking events
____Contests
____Tape Chair
____Other____________________
RESOURCE INFORMATION
Everyone knows something about something that would be helpful to our members in compiling our books. These fingertip resources can be an invaluable asset to our chapter. Nothing is too insignificant, so please share what you know.
We invite our long distance members to offer their services for online workshops.
Please list any areas in which you have a particular expertise in the following topics.
OCCUPATIONS – For example: law enforcement, library work, accounting, child care, insurance, nursing, parliamentary procedure, firefighting, taxes, etc.:
____ I would be willing to give a workshop on this topic(s)
____ I would not be willing to give a workshop on this topic(s)
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GEOGRAPHICAL KNOWLEDGE – For example: if you’ve spent time living abroad, if you’ve lived or live in a US city that might be used as a setting for a book or maybe you’ve already researched a given place and would like to share that information, etc:
____ I would be willing to give a workshop on this topic(s)
____ I would not be willing to give a workshop on this topic(s)
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CRAFT OF WRITING WORKSHOP INFORMATION:
____ I would be willing to give a workshop on this topic(s)
____ I would not be willing to give a workshop on this topic(s)
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I have a friend, acquaintance, family member, coworker who might be willing to give workshops on the following topic(s):
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HOBBIES AND INTEREST – such as horses, knitting, sports, dogs, gardening, collecting, antiques, etc.:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
OTHER:
____ I would be interested in gathering marketing news and running or helping to run the ACRA News loop
____ I would be interested in procuring, designing and maintaining a web site for ACRA
Please list here any areas that you’d be willing to participate in that have not been mentioned in this form:
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
ACRA 2010 Application Form.pdf PDF of this application.
Any questions about this form or membership in general should be sent to Miriam Van Veen
Please email Miriam for instructions on where to send the completed application form and your check, made payable to ACRA.
ACRA’s mailing address is: Post Office Box 18342, Jacksonville, Fl 32229
In accordance with our membership application process and eligibility requirements, as written in the ACRA Bylaws and Policy & Procedure: Upon review of this application, the ACRA Board of Directors reserves the right to accept or decline any application for membership in the Ancient City Romance Authors for reasons other than those prohibited in the above documents.
