West Virginia Writers 
APPLICATION FOR MEMBERSHIP
(Printable Version)


NAME                                                                                         

ADDRESS
                                                                                   

CITY
                                                                                            

STATE
               ZIP                   

COUNTY
                                                                                    

PHONE                                                                                       

E-MAIL ADDRESS                                                                   

REFERRED BY                                                                         

WRITING INTERESTS                                                            

                                                                                                     

MEMBERSHIP TYPE                                                               

(A) Adult Membership - $20 per year
(S) Student Membership - $10 per year
(Y) Youth Membership (under 18 years of age) $5 per year

Due annually on July 1

MAIL CHECK AND APPLICATION TO:

WEST VIRGINIA WRITERS, INC.
HC 72 Box 232
Keyser, WV 26726
Questions?  Call 304-790-2838
or write writemyst@yahoo.com