Printer Friendly Member Application Form

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	Name:_____________________________________________________________ Address:___________________________________________________________ City:______________________________________ State: _____ Zip:__________ Home Telephone: __________________________ Fax: _____________________ Are you a professional writer? Y __ / N __ F/T or P/T Writer:______________ Are you an NASFA Member? Y __ / N __ Would You like to Join? Y __ / N __ Name your favorite genre to work with:________________________________________________ Tell us about your favorite place to be in when you write: ________________________ ____________________________________________________________________ *Please Send Information About: The National Alliance of Short Fiction Authors: Y___ N ___* Competition Fees for Two* Entries:.............. $ 15.00 (Does not Include a copy of book) Plus: Additional Scripts:.....................X $ 10.00 $__________(Maximum of three per author) Plus: Copy of Books:..........................X $ 9.00 $__________(No Limit) * Or: Student Membership:.................X $ 10.00 $__________(Copy of F/T Registration Required) Plus: Author / Adult Membership:.........X $ 45.00 $_________(Includes Subscription to Quarterly Book and author web page) Total Fee* Submitted................................$__________(Second member is half price!) Why wait - sign up a friend today! We can send you a great looking gift certificate. Please note - manuscripts must belong to the submitting authors. Furthermore, each person, by the act of submitting their work, warrants that they are the original creator and have the exclusive and sole ownership of all copyrights pertaining to the work being submitted, now and forever, notwithstanding certain temporary publishing assignment of rights, that which may include this organization. Please Make Checks To: Timson Edwards, Co. * If Student is a Minor, Parent Or Legal Guardian Must Sign The Back Of This Form NASFA, is an organization dedicated to the art of creative short fiction, book manufacturing and literary excellence. The Wildwood Reader is published by: The Leaping Frog Press an imprint of Timson Edwards, Co. PO Box 55-0898 Jacksonville, FL 32255-0898 Click here to return to the Author Listings page.

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