Mobile, Alabama

Gulf Coast Chapter Romance Writers of America®

Membership Form - 2008/2009

Name: ______________________________

Address: ______________________________

City: _________________________ State: _____ Zipcode: _____

Phone: _______________ E-Mail: _______________

Website: ______________________________

Date: _______________

RWA® Membership No. __________

Annual dues are $24.00 payable each August.

Make check or money order payable to GCCRWA--Mail or hand-deliver to:

Donna Harris, Vice President Membership, 8024 Hwy 614, Moss Point MS 39562

or

Fran McNabb, Treasurer, 9104 W. Simmons Cir, Ocean Springs MS 39564