|City, Province, Postal Code|
(if different from legal name)
Please indicate if you accept having your email address or other electronic address of your choice (web address, etc.) appear in the Members Only section of the website, allowing easier connections between members. Your name will appear as a live link. By clicking on it, the person will be taken to the address you provide.
|Yes. Please link the email address on this form.|
|Yes. Please use the following link:|
|No. I do not want a contact link.|
*Additional Author Identities: If you are published under more than one name, you can add that name, as a separate identity, for $65. This will allow you to give your other author name its own bio and separate exposure for marketing purposes.
|Additional author name(s)|
DONATION for program development: In addition to my membership dues I want to donate $__________