Application for Membership in the<BR> DOG WRITERS ASSOCIATION OF AMERICA

Application for Membership in the DOG WRITERS ASSOCIATION OF AMERICA INCORPORATED

Date of Application: _________________________

Type of Membership (check one): Professional (paid for writing) Associate

Name: _____________________________________

Home Address: ___________________________________________________ Phone: _______________ Fax: ________________ E-Mail _________________

Business Address: _________________________________________________ Phone: _______________ Fax: ________________ E-Mail _________________

Are you a (check appropriate categories):

Writer Journalist Editor Publisher Broadcaster Photographer Artist Other ___________________

Do you work on a freelance basis? ________
What is the name of your media affiliation or company, if any, and how long have you been with them?____________________________________________________ Frequency of publication or broadcast: ___________________
How often does your work appear? _______________
How much of your work is about dogs? ___________
Have you done this work for more than one year? ___________
Are you paid for this work? ______________
What other dog writing (or dog-related work as circled above) have you done? _____________________________________________
If you belong to any other dog organizations please list here and offices held. ______________________________________________________________________

You may attach additional information or a resume to this application.

Two DWAA Members must sponsor you. Please consult the Secretary about sponsors. List Sponsors:

1. __________________________________ 2. ___________________________________

Signature of Applicant: __________________________________________________

To be considered, all applications must include three current published examples of your work plus a check for $75 ($35 initiation fee and $40 first year's dues). Make checks or money orders payable to DWAA in US Dollars only. If the application is not approved, the check will be returned. Fees and dues are subject to change.

PLEASE RETURN THE COMPLETED APPLICATION TO THE SECRETARY:

Pat Santi * DWAA, Secretary * 173 Union Road * Coatesville, PA 19320 * E-Mail Rhydowen@aol.com