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Date: Name:   Address: City:     State:     Zip: Phone: Fax: E-Mail: website: P-Professional membership is open to any individual who satisfies ONE of the following qualifications: (Note: An applicant for Professional Membership must show that he/she, has made a profit or earned an income with his/her writing skills. The sections below are designed to reveal that level of achievement) Section A Author or co-author of a commercially published book or a stage play, motion picture script, radio or television script, which has been sold and commercially produced. (Note: self-published authors will be accepted as professionals at the discretion of the board) Title of your book or script:             If you have published more than one book or script, you may choose any of your titles as an example.                           Please include one copy of your book with your application form for board review. Publisher or Producer:  ISBN or other identification: Configuration: Conventional Motion Picture Audio Book Teleplay E-Book Stage Play CD Other Print on Demand Section B Author or co-author of at least six poems, 6 short stories, or magazine articles that have been sold. List six of your stories, poems or articles that have been carried in magazines, newspapers, anthologies or on web sites (other than your own) and for which you have been paid. Magazine Issue month and year Title of your story or article Section C Is a writer with a minimum of three (3) years' professional experience who is or has been employed by one of the accepted media: Professional experience as a publishing executive, editor, journalist or free-lancer requiring editing, critiquing, writing and/or proofing Company Name: How long engaged in this capacity? Nature of your writing tasks: Describe current projects: Professional experience as a professor, teacher or writing instructor for schools or industry. Name of institution: How long engaged in this capacity? Nature of your writing tasks: Describe current projects: Section D Collaboration, etc. Have you collaborated, on two or more occasions, to write more than 50% of books which were credited to other people? Yes PLEASE ATTACH DOCUMENTATION. The review board considers examples of your published writing of particular interest. Attach tear sheets, excerpts, book, identified reader comments, reviews and other supporting documentation. Also include clear descriptions of your current projects: Information for Directory On the two lines below, allowing 70 spaces per line, please write what you would like to tell others know about your writing, and as you would like this information printed in the Directory. Include key words; book titles, children's stories, genre(s), mystery, adventure, mainstream, war, crime, poetry, etc.