
Return to LIRW Home Return to LIRW Join New Member Application for the Long Island Romance Writers, Inc. Please submit this form for application to the Long Island Romance Writers, Inc. You may submit online here or print out this application and mail it to the address below. Applications take approximately seven days to process. After membership approval, you will be instructed how to submit payment of dues. Dues for general members are $35 annually, $17.50 after June 30 for half-year dues. PLEASE NOTE: If you were a member of the LIRW in the past but your membership has lapsed, please fill out this NEW MEMBER APPLICATION, thank you. If you have any questions, please contact us at longislandromancewriters@gmail.com . We look forward to meeting you! I am: applying for first time membership in LIRW formerly a member of LIRW I have read and agree to abide by the LIRW Chapter Bylaws and Civility Code Please initial I am applying for: General Membership Associate Membership First Name: Last Name : Pseudonyms: Name I prefer to use in the chapter: Address 1: Address 2: City: State: Zip: Phone Number (123-456-7890): Email: RWA Number: I am a member of: PAN-Published Authors Network PRO Neither I am published in Romance Fiction. I am published in Non-Romance Fiction. I am published in Non-Fiction. I am not yet published. Any publications credits you'd like to share? What do you write? i.e., YA, paranormal, suspense, sweet, sexy, etc. How did you hear about the LIRW? Do you belong to any other writer's organizations? Anything else you'd like us to know? (such as website, blog, FB, T, "please don't share my Pseudonym", "please don't give out my phone number on lists given to membership", etc.): If you choose, you may print out this application and mail it to our Secretary, who will process it. Please allow extra time for processing when mailed. Send to: The Long Island Romance Writers, Inc. Yolanda Ramirez, LIRW Secretary PO Box 33 Holtsville, NY 11742 Thank you for your application to the LIRW!

Return to LIRW Home Return to LIRW Join

New Member Application for the Long Island Romance Writers, Inc.

Please submit this form for application to the Long Island Romance Writers, Inc. You may submit online here or print out this application and mail it to the address below.
Applications take approximately seven days to process. After membership approval, you will be instructed how to submit payment of dues.
Dues for general members are $35 annually, $17.50 after June 30 for half-year dues.
PLEASE NOTE: If you were a member of the LIRW in the past but your membership has lapsed, please fill out this NEW MEMBER APPLICATION, thank you.

If you have any questions, please contact us at longislandromancewriters@gmail.com .

We look forward to meeting you!

I am:
applying for first time membership in LIRW
formerly a member of LIRW

I have read and agree to abide by the LIRW Chapter Bylaws and Civility Code
Please initial

I am applying for:
General Membership
Associate Membership

First Name: Last Name :
Pseudonyms:
Name I prefer to use in the chapter:
Address 1:
Address 2:
City: State: Zip:
Phone Number (123-456-7890):
Email:
RWA Number:

I am a member of:
PAN-Published Authors Network
PRO
Neither

I am published in Romance Fiction.
I am published in Non-Romance Fiction.
I am published in Non-Fiction.
I am not yet published.

Any publications credits you'd like to share?

What do you write? i.e., YA, paranormal, suspense, sweet, sexy, etc.

How did you hear about the LIRW?

Do you belong to any other writer's organizations?

Anything else you'd like us to know? (such as website, blog, FB, T, "please don't share my Pseudonym", "please don't give out my phone number on lists given to membership", etc.):

If you choose, you may print out this application and mail it to our Secretary, who will process it. Please allow extra time for processing when mailed.

Send to:

The Long Island Romance Writers, Inc.
Yolanda Ramirez, LIRW Secretary
PO Box 33
Holtsville, NY 11742

Thank you for your application to the LIRW!