Christian Writers of the West Membership Application

Date: ______Christian Writers of the West Membership Application

Name ______Pseudonym ______Address______Home Phone ______Cell Phone ______Email (for CWOW communication) ______Website and/or Blog ______Facebook or other social media address ______Birthday (Month and Day) ______Occupation ______May we share this information with the other members? __Yes __No

Main genre of interest: (Add R for Romance, I for Inspirational) _____ Contemporary _____ Historical _____ Young Adult _____ Women’s _____ Paranormal/Science Fiction/Fantasy _____ Suspense/Mystery/Thriller _____ Non-Fiction _____ Devotional/Bible Study _____ Other______My areas of expertise and/or hobbies include the following and I am willing to be contacted to share my knowledge. (use the back if you need more space) ______Publishing History (check all that apply) __ Not published (yet) __ Seeking publication and/or agent __ Published (book length or anthology) by a traditional publisher Publishers and Genres: ______Self-published or non-traditional publisher Titles and Genres: ______Other types of publications (novellas, devotional, articles) ______

Version 1-24-13 Date: ______Ways I’m willing to help with the club: (*officer positions requires 6 months of membership) __ President* __ Vice-president* __ Treasurer* __ Secretary* __ Membership Coordinator __ Newsletter Coordinator __ Phoenix Rattler Contest Coordinator/Team Member __ Other – if you have other ideas to help others in their writing journey, share here: ______

Tell us more about yourself – What do you hope for in a writing club such as CWOW? What have you liked most about other writing organizations you’ve experienced? How have you participated in other writing organizations? ______

Please be sure to speak up, speak out, volunteer, participate, and – most of all – make yourself at home. We’re glad to have you.

Version 1-24-13