THPW Membership Registration

Date

Member Status

New MemberRenewal

Name *Please use real name. Include pen names in parenthesis.

Address

mailing addressStreet AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Email *

Phone *

Alternate Phone

Website URL Please include a link to your website, if you have one.

What do you write?

genre examples: fantasy, western, romance

How did you hear about us?

FriendLibraryNewspaperTelevisionSocial MediaOther

May we share your email with other members for collaboration purposes?

YesNo

Donations Panhandle Professional Writers dba Texas High Plains Writers is a non-profit charitable 501(c)(3) organization. If you would like to make a donation in addition to your annual dues, please enter the amount you wish to donate next to the event for which you want your donation applied. THPW will provide you with a receipt for tax purposes for your donation.

Dues and Donations

Please note that donations are separate and apart from the Annual Membership Dues.Annual Membership Dues $40General Use Donation

Required Acknowledgement *

Payment must be received before Membership is valid.I understand that my membership is not active until payment is received.

How will dues be paid? *THPW accepts checks, cash (in person/ at meetings) or credit cards online. Our mailing address is: Texas High Plains Writers PO Box 19303 Amarillo, TX 79114

THPW Membership Registration

Panhandle Professional Writers dba Texas High Plains Writers

P.O. Box 19303, Amarillo, TX 79114

Online Registration

Verification

(c) 2018 Panhandle Professional Writers D/B/A Texas High Plains Writers

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