Mobile, Alabama

Gulf Coast Chapter Romance Writers of America ™

Membership Form - 2007/2008

Name:_________________________________________________

Address:______________________________________________

City:___________________________State:____Zipcode:_____

Phone:_____________E-Mail:_______________

Website: _________________________________

Date: _______________

RWA ™ Membership No._______________

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Annual dues are $24.00 payable each August.

Members joining after the August deadline contact Donna Harris for pro-rated dues.

Make check or money order payable to GCCRWA--Mail or hand-deliver to:

Vice President Membership

Donna Harris

8024 Hwy 614

Moss Point MS 39562

For more information call 228.229.9339 or email info@gccrwa.com