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Pikes Peak Writers Membership Application
Print out this form and mail it to the address at the bottom of the page.

* Required Information

Is this a new membership application or a change/renewal of existing information? 
       
Name: *    
E-Mail: *    
Address:*      
City: * State:*
Phone: *  Zip *:
Country:    
Are you published or unpublished? 

If you are published, please mark all areas where you are published:

Novel-length fiction
Short stories
Book-length nonfiction
Magazine articles
Technical Manuals
Other : 

       

What genre do you typically write in? Mark all that apply.

Thriller/suspense
Horror
Science Fiction
Fantasy
Mystery
Romance
Literary
Mainstream
Young Adult
Children's
Non-fiction
Short story
Other: 
 

       

Published works:

 

Pseudonym(s):    
       

List any areas of expertise you might be willing to share with the group or individual members (this can include past or present occupations, education, life experiences, places you've lived or visited, anything you're knowledgeable about):

 

If you would like us to include you in our New Members News, please tell us a little about yourself, in 25 words or less. (This information will be included under Our Newest Members on PikesPeakWriters.com, and in the Pikes Peak Writers NewsMagazine.):

To ensure that you are a person, not a machine, please type the black characters into the box:    

  

Please PRINT this page before clicking Submit
An email confirmation will be sent to the email address you entered above when the form has been successfully submitted.

Click Submit to be taken to your confirmation page, where you can use PayPal to pay for your membership. Or print this form out and mail with your check for $40 to:

Pikes Peak Writers
427 E. Colorado Ave #116
Colorado Springs, CO  80903

Please allow a few days for your membership to be processed, you will receive website access information at the email address submitted above.