Name Spouse

 

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Phone:  Home Office

 

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Type of writing you do:  

Fiction     Nonfiction     Poetry      Radio/TV

Screen     Theater     Other

 

Other

 

Membership level you're applying for: 

Active     Associate     Sustaining      Patron

 

Occupation other than writing:

 

Pseudonyms (if any)

 

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Agent's Address:

 

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How did you learn about WWA and this Web site?

 

PLEASE PROVIDE a complete list of your publications and/or writings that have been printed, produced and/or performed on radio, TV, screen, and/or theater in the space below. For books, please include date of publication and name of publisher; name of periodical and date of publication; for theater, film, TV, or radio include date and place of exhibition or broadcast. NOTE: Each published/produced work that has been paid for in whole or in part by the author must be so identified with an asterisk (*).  Also, please mark with a pound sign (#) those works that are set in the American West and/or early frontier.

 

I attest that all information submitted on and in support of this membership application is true. (please check box)

 

Thank you for applying for membership with Western Writers of America.  Once your application has been reviewed you will be notified of whether or not your membership is approved, along with a statement of dues.  Click on the following link for more information on membership qualifications.