Membership Application Form
Print form to send by mail or cut-and-paste into an email.
Click here for a printer-friendly PDF version.
Contact DetailsName: ______________________________________________________
Company: ___________________________________________________
Address: ____________________________________________________
City: ____________________________ Prov: _________ P/code:______
Tel: _____________________________ Fax: ______________________
Email: ______________________________________________________
Website: ____________________________________________________
Chapter:____________________________________________________
Membership (please indicate below):
Professional ___ Associate ___ Student ___
Total Pro-rated Membership Dues: $______________
*NB: Student Memberships are not pro-rated
How did you hear about PWAC?
PWAC Website ____ PWAC Member ____ Other ____
Name of PWAC Member who referred you: ________________________
Press Card
No card ____ Card no photo ____ Card with photo*____
* = hard-copy and digital photos are accepted
Payment Method (dues payments once accepted are non-refundable)
VISA/MasterCard___ Cheque (payable to PWAC) ___ PayPal (send funds to info@pwac.ca) ___
Name on Credit Card: __________________________________________
Card Number: ______________________________________ Exp: _____
Materials to Include:
- Professional Membership: samples of any three magazine and/or newspaper articles and/or major writing projects published within the previous 24 months OR a sample of one published non-fiction book.
- Associate Membership: one sample of any magazine or newspaper articles or major writing projects published within the previous 12 months.
- Provide title, name of publication, date published and length.
- Include samples of all the listed materials. Hard copy or electronic copies of materials are accepted.
- Student Membership: proof of full-time student status at a recognized post-secondary institution in Canada.
How would you like to receive future invoices?
Post ____ Email____
Information Sharing
Do you grant permission for your contact details (name, address, telephone number, email address) to be shared with other PWAC members for non-PWAC business? Yes ____ No____
Optional Information for Tracking Purposes Only
Year of Birth ____ Gender____
PWAC's Privacy Policy outlines how personal information is used and disseminated.
If you have any other questions, please email or call (416-504-1645 ext.1) the PWAC National Office.
Submit applications to:
PWAC National Office
Membership Application
215 Spadina Ave, Suite #123
Toronto ON M5T 2C7
E: info@pwac.ca
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