HIS Writers
Membership Application

 

National membership is required before local chapter membership can be granted.
To join ACFW and become a national member, click here.

 

 

CONTACT INFORMATION
*First Name:	A value is required.	*Address:		A value is required.
*Last Name:	A value is required.	*City:		A value is required.
*Email:	A value is required.Invalid format.	*State:		A value is required.
*Home Phone: (xxx-xxx-xxxx)	A value is required.Invalid format.	*Zip:		A value is required.Invalid format.
Cell Phone: (xxx-xxx-xxxx)	Invalid format.	Work Phone: (xxx-xxx-xxxx)		Invalid format.
___________________________________________________________________________________________
AUTHOR INFORMATION
*Do you consider yourself a full-time writer?:	Please choose one... Yes No Please select an item.	Genre(s):	Exceeded maximum number of characters.
Pen Name(s):		Website(s):
Birthday:	Please choose one... January February March April May June July August September October November December (Month)		Please choose one... 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 (Year)
*Are you published?:	Please choose one... Yes No Please select an item.	Name of publisher:
Please let us know of any literary activites you are involved in outside of writing (hold down CTRL key to make multiple selections):	Choose all that apply... Agent Editor Publisher Publicist Journalist Librarian Illustrator Teacher Other	Please specify "other:"
___________________________________________________________________________________________
STATEMENT OF FAITH
Statement of Faith:	Jesus is God incarnate; salvation comes through him alone: Jesus answered, I am the way and the truth and the life. No one comes to the Father except through me. John 14:6 NIV The Bible is God's Word: All Scripture is God-breathed and is useful for teaching, rebuking, correcting and training in righteousness 2Tim. 3:16 NIV
	Please make a selection. Please make a selection.*I agree to the Statement of Faith
HIS Writers reserves the right to refuse an individual's membership application.
___________________________________________________________________________________________
PAYMENT
*Method of payment:	Please choose one... PayPal/Credit Card Check Please select an item.
HIS Writers membership dues are $15 annually and due upon submission of this application. They are good through the end of the year and renew each January.
___________________________________________________________________________________________
	Please make a selection.*I acknowlege that I am a member of ACFW national in good standing.
	Please make a selection.*I acknowledge that I am over 18 (ACFW limits membership to persons 18 years of age and older)
	*Today's date:   A value is required.Invalid format. (mm/dd/yyyy)
	*Required item
___________________________________________________________________________________________
This Membership Application is for new members only. If you are an existing member and wish to renew your dues, please click here.
___________________________________________________________________________________________