Please fill out our Membership Application Form
* required information

Name:	*
Email:	*
Occupation Title:	*
Business Name:	*
Business Address: City: State, Zip:	*
Home Address: City: State, Zip:	*
Please indicate whether you would prefer to receive mail at home or work:	*
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Purchase Membership Online or pay via Snail Mail ?:	*
New Membership ($40) or Sponsoring Membership ($150 per yr. Local sponsoring members have the full rights and privileges of active members. In addition, members are entitled to have a link on the chapter web site and to be listed in the chapter newsletter.)	*

Your name is a “required entry” into the WNBA National Directory. Uncheck this box if you don't want your information such as home address, phone number, email, etc in the WNBA National Directory

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Opportunities for greater involvement (optional) Your responses in this section will help us with our planning. 1. Ongoing chapter activities: (please check the box next to the activity you are interested in) I would be interested in exploring further involvement as...

	A member of the chapter's governing board (entails attending quarterly planning meetings; other responsibilities on a voluntary basis)
	Editor or contributor to the chapter's newsletter
	Chapter correspondent for WNBA National's newsletter, The Bookwoman
	Web mistress or assistant for the chapter's postings on the National web site
	Email coordinator, membership chair, publicity chair, or corresponding secretary
	A member of the support committee for the Judy Lopez Awards for Children?s Literature (you could choose among a wide range of helpful tasks)

2. Email networking: I would like to be part of an informal WNBA/LA network that would enable me to learn/tell about book-related or other worthwhile events and see who else from our group might like to go. My interests are:

	General fiction and non-fiction (author signings, lectures, etc.)
	Children's literature
	General cultural events (museum exhibits, concerts, etc.)
	Movies
	Other:

3. I belong to the following literary or cultural groups. I would be willing to pass along news of their events. I could share news of appropriate WNBA events with them. 4. Program and small-group meetings: I would like to suggest the following topics for general programs or workshops: I am willing to be a program speaker or workshop facilitator on the following topics: I am interested in attending smaller, more frequent meetings organized as a book discussion group a writing workshop 5. Venues:

	I would consider hosting a members-only event in my home.
	Through my employment or my membership in other groups, I can suggest a free or low cost meeting room or a pleasant, reasonably priced restaurant where WNBA could hold an event open to the general, book-loving public. Call me about it.
	I know a library, museum, bookseller, etc. that could provide both a program and a venue (both of which could be combined as a tour) for a special meeting.

In order to complete your listing in the WNBA National Directory, please check the appropriate boxes below. These will be your “search” professions/keywords in the Directory.

	Los Angeles		Indexer
	Advertising Promotion		Journalist
	Agent		Librarian
	Artist Designer		Library Administrator
	Attorney		Library Staff
	Author		Media Specialist
	Author Children's Literature		Other
	Author Fiction		Permissions/Copyrights
	Author Nonfiction		Poet
	Book Club		Print/Film/Broadcast/Media
	Book Packager		Professional Training
	Book Production/Manufacturing		Proposal Writer/Editor
	Book Trade Allied Association		Publicity/Public Relations
	Bookseller		Publisher
	Bookstore		Researcher
	Children's Literature		Retired
	Community Service		Reviewer Critic
	Consultant		Sales Marketing
	Copy Editor/Proofreader		Subsidiary Rights
	Desktop Publishing		Teacher Instructor
	Editor		Technical Writer-Editor
	Electronic Publishing		Translator
	Exhibitions/Library/Museum		Web Designer
	Freelance Editor		Wholesaler Distributor
	Freelance Writer		Writer
	Human Resources/Recruitment

Note: After you submit this application a new page will direct you to your payment.