Mail-In STAR Membership Form

Name: _________________________________________________

Address: _________________________________________________

City: ____________________ State: ________ Zip: ____________

Daytime Phone incl a/c) ____________________   Evening or Cell #: _______________________

E-mail Address: _________________________________________________

Membership Fees enclosed?
(check or money order payable to Spacecoast Authors of Romance):

$45 ___ First-Time Active Member                   $45 ___ Associate Membership

$25___ Membership renewal – Please indicate: ____Active or   ____Associate

Are you a member of RWA*?  ___ Yes     ___ No           RWA Membership Number _____________
*Note: Membership with Romance Writers of America (RWA) is mandatory within 90 days or STAR membership is null and void.

Are you a PAN or PRO Member with RWA?: Yes, I’m ______

THE FOLLOWING INFORMATION WILL BE ADDED TO YOUR LISTING ON OUR MEMBERS PAGE.

Please list me under ____ my real name       _____ my pen name, which is: __________________________________________

My website address: _____________________________________________________

My facebook page: ______________________________________________________

My Twitter page: ______________________________________________________

If you wish to have a bio page, please send the text to admin@authorsofromance.com. You may also include a photo as an attachment to that email. The image must be either a .jpg, .png, or .jpeg and should not be larger than 1 mb.

Print this page and mail with your check to:

SpacecoasT Authors of Romance
P.O. Box 410787
Melbourne, FL 32941