The Golden Network Membership Form

RWA Member Number:
Your Real Name:
Pen or Other Name (optional):

Email Address (this is the address you will use
on The Golden Network email lists):
Web Site Address (optional):
Mailing Address:
Phone Number:
Year and category of first Golden Heart final:
Years and categories of subsequent Golden Heart finals (optional):
Year booted to alumnus member status (optional):
Conference where you were (or will be) booted (optional):
First Book Sold (Title/Publisher/Release Date) (optional):
Upcoming Book Releases (Title/Publisher/Release Date) (optional):
Membership dues are $10. Will you be paying by PayPal or check?

 
    

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