Application for Membership in
California Writers Club
SF Peninsula Branch
Complete and print this form. Send it along with your check via US mail to:
California Writers Club - SF Peninsula Branch, ATTN: Membership Chair
PO Box 853, Belmont, CA 94002-0853

 All fields are required.

Date of Registration:
Name: 
Address: 
City:
State:   
Zip Code:  
EMail:    
Phone:
I am applying for
(select  one):  		Active (published) membership
Associate (non-published) membership
I enclose for consideration
(select one): 		a clip of a published work (for Active membership)
a writing sample (for Associate membership)
I write in the following area(s)
(check all that apply): 		Novel    Short Story Poetry
Non-Fiction  Book  Non-fiction article
Journalism  Editing
Screenplay  Script  Play production
Other: 

 
I enclose a check payable to CWC SF/Peninsula Branch for $65 ($45 yearly plus a $20 one-time processing fee). 
Note: If after January 1, half-year dues of $42.50 ($22.50 dues plus $20 one-time processing fee). 		 
 

 

Signature of Applicant _________________________________________________        Date: ___________