Name:______________________________________________________________________________________

Address:____________________________________________________________________________________

City:_________________________________________________________________ State:______ Zip:________

Telephone:____________________________________________________________

Email:______________________________________________________________________________________

Website:____________________________________________________________________________________

I am a published ___ unpublished ___ writer.
I am interested in fiction ___ non-fiction ___ poetry ___ 
I am interested in article/short story ___ book/novel ___ length writing.

I am interested in the following genres: ______________________________________________________________

___________________________________________________________________________________________

League Membership dues are $15.00.

Chapter dues are $20.00 and include all chapter activity fees, 10 issues of the chapter newsletter, regular monthly daytime and evening meetings, and attendance at chapter workshops and seminars at member rates.
Guests may attend two meetings before paying dues.

Please include a check or money order payable to IWL Coeur d'Alene Chapter for $35.00.