Music City Romance Writers
Membership Application 

Music City Romance Writers was formed to benefit Romance Writers of America® members in our area, to allow them to utilize its extensive network. (Note: Only members of RWA® may join MCRW, so be sure to include your RWA membership number below.) The following are the benefits offered to members of MCRW: 

Annual dues: $25 (Make checks payable to Music City Romance Writers.) 

Mail application to Trish Milburn, P.O. Box 140875, Nashville, TN 37214-0875. 

Name: ____________________________________________________________________ 

Street address: ______________________________________________________________ 

City and state: ____________________________________ Zip Code: _________________ 

Phone No.: _____________________________ e-mail address: _______________________ 

Emergency Contact & Phone: __________________________________________________

Date of birth (for birthday greetings in the newsletter): _________________________________ 

Website address (if applicable): _________________________________________________ 

2nd Website address, such as a blog (if applicable): _________________________________________________ 

RWA Membership No. (required): ________________________ 

Member of PRO or PAN?__________________________

Are you published in novel-length romance?            Yes _____  No _____ 

If yes, who is your publisher(s)? __________________________________________________ 

Are you published in short fiction or outside the romance genre?  If yes, feel free to elaborate:

___________________________________________________________________________ 

___________________________________________________________________________ 

SIGNED: _________________________________________  DATE: ___________________

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