Membership Application (Please Print)

Name: _______________________________________   Date: ___________

Address: __________________________________________________________________

 City: __________________________________ State: _____________ Zip: _____________

 National RWA Membership Number: __________ Birthday (Month & Day): ______________

 How would you like your name to appear on our roster? _____________________________

 Phone Number: ______________    May we list it on our roster? Yes __ No__

 E-Mail Address: _______________  May we list it on our roster? Yes __ No __

 Web site Address: ______________May we list it on our roster? Yes __ No __

 Writing Information:

 ___ Published in book-length romantic fiction     

___ Published, Other genres 

___ Unpublished 

Category/categories of romance you write: _________________________________________

 How did you hear about Iowa Romance Novelists? ___________________________________

 ____________________________________________________________________________

 Iowa Romance Novelists is a local chapter of Romance Writers of America.  Membership in Romance Writers of America is a prerequisite to joining Iowa Romance Novelists.  IRN members agree to embrace the goals of Iowa Romance Novelists and agree to be bound by its Bylaws and Policies and Procedures.           ___________________________________________

Thank you for your interest in IRN.  Cost of membership is $30.  Please make checks or money orders payable to Iowa Romance Novelists and mail with your application to:

You may reach the IRN President by e-mail at: iowaromnovel@yahoo.com

For IRN processing use only: Please do not write in this section.