Music City Romance Writers
Online 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: 

Application Form (Payment information will be on the next page):

Name:       

Street address:       

City and state:       

Zip Code (or other information, if outside the US):       

Phone No.:

Cellphone:

E-mail address:       

2nd e-mail (optional):

Emergency Contact Name:       

Emergency Contact Phone:

Date of birth (may omit year):       

Main web site address (if applicable):

Secondary website address, such as a blog or penname site (if applicable):

RWA Membership No. (required):       

Member of PRO or PAN? (Please type No, PRO or PAN) 

Are you published in novel-length romance? (Please type yes or no)          

If yes, who is your publisher(s), what books have you released recently, etc?  This can be shared with our members as your introduction.

 

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

___________________________________________________________________________ 

By initialing here, I signify that the information I have shared is true to the best of my knowledge:       

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