New Member

New Member Application

    Contact Info

    First Name *

    Last Name *

    Informal/Pen Name

    Email *

    Primary Phone *


    Secondary Phone


    Street address1*

    Street address2

    City *

    State *

    Zip *

    Online/Social Media

    author website/blog

    Twitter Handle

    Facebook Profile

    Facebook Author Page

    GoodReads Profile

    Pinterest Profile

    Writing Experience

    You don't have to be a published author to join, as long as you have the desire to write and get published. Please upload at least five pages of your writing and cite up to three of your most recent writing projects, published or in progress.

    Upload Writing Sample (pdf|txt|doc|docx) *

    Publication #1

    Title

    Format

    Brief Description

    Publication Status

    Publication #2

    Title

    Format

    Brief Description

    Publication Status

    Publication #3

    Title

    Format

    Brief Description

    Publication Status

    Genres

    Genres (check all that apply) *

    Registration Type

    Primary CWC Branch (If Applying as Dual Member)

    Who/what referred you to CWC Tri-Valley Branch?

    Volunteer Interests

    Tri-Valley Writers is an all volunteer organization and we depend on our members to be generous with there time and talents.

    Volunteer Interests (check all that apply) *

    Other Skills

    There is a one-time enrollment fee of $20 in addition to the $45 annual dues for a total of $65. (Applications accepted between January 1 and June 1 pay the $20 enrollment fee and half-year dues of $22.50 for a total of $42.50.)


    Membership Type
    Full Name & Email Address



    Note: New members MUST submit the application form with writing samples. Please fill out the application above (including attaching writing samples) —OR— email  the application form (see below) and 5 pages of sample writing to: membership@trivalleywriters.org. Please state “New Member” in the subject line of your email. Or you may snail mail your application and writing samples to:

    CWC Tri-Valley Branch
    Attn: Membership Chair
    4682 Chabot Drive #10953
    Pleasanton, CA 94588

    You may also pay your membership fee via snail mail your payment to the above address.