Referred by:_______________________________________________________
Are you published? _____Yes _____No
Are you RWA PRO®? ____Yes ____No
Book-length Romance: Conventional or E-published/Audio
Novella or short-story romance
Other: ________________________________________________________
Are you a member of PAN (RWA® Published Author's Network)____Yes or ____No
How long have you belonged to RWA®?_______________ Outreach? _____________
Outreach is operated entirely by volunteers. As we add new programs and
services,
we need more people to help out. Would you be willing to add your
name to our list of those
who are willing to assist? _____Yes _____No
To contribute to RWA's® Literacy Program, please indicate an amount and then
include
the amount you wish to contribute in your membership renewal check
or money order.
____$1 ____$2 ____$5 ____Other
No amount is too small if it helps someone learn to read.
Sign me up!
My $30.00 membership fee in Outreach International is enclosed. (Check or
money
order in U. S. FUNDS ONLY.) There is a $25 charge for returned unpaid
checks.
Applications take 4-6 weeks to process. Thank you for your patience.
Signed: ____________________________________ Date: ____________________
Mail application form and check or money order made out to OIRW to:
Nina Pierce
Outreach International Membership Chair
61 Dyer Street
Presque Isle, Maine 04769
nina@ninapierce.