WC - Application/Renewal Form

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MEMBERSHIP APPLICATION/RENEWAL FORM
Please download and/or print, fill out, and mail to the address at the end of this form.

(Check or circle the correct category)
NEW APPLICATION
RENEWAL

NAME ____ __________________________________________________________
Title First Middle Last Appel

NON-NATIVE
DESCENDANT OF __________________________________
CITIZEN OF __________________________________

ADDRESS __________________________________________________
street

__________________________________________________
city state zip

HOME PHONE __________________ FAX ______________________

EMAIL ADDRESS: ______________________________

WEBSITE: ______________________________

OFFICE __________________________________________________
ADDRESS street

__________________________________________________
city state zip

HOME PHONE __________________ FAX ______________________

DATE OF BIRTH (Month/Day/Year) ___ / ___ / ________

BIRTH PLACE _____________________________________

NOTE: This information is used for member ID purposes only. Only the month and day of birth are published in the Wordcraft Circle Birthday Calendar.

Membership Category
Please check or circle the category which applies to you.

REGULAR (Native and non-Native) - Dues are $40.00 per year
STUDENT (Native and non-Native - Dues are $25.00 per year
SENIOR (50+, Native and non-Native) - Dues are $25.00 per year
INDIVIDUAL (Publisher/Literary Agent/Publicist)- Dues are $50.00 per year
ORGANIZATION (Library/Educational Institution) - Dues are $75.00 per year
SPONSOR ($100+)
PATRON ($500+)

Writing - Storytelling - Speaking
Style & Experience
In the following section, please identify your level of experience.

    Beginning level is for those who have 0-4 published writings and/or 0-6 public storytellings/speaking engagements.
    Emerging writers/storytellers have 5-15 published writings and/or 7-30 public storytellings/speaking engagements.
    Professional level is for those with 16 or more published writings and/or 31 or more public storytellings/speaking engagements.

Writing Style and Experience
Please check or circle the appropriate choice.

CREATIVE - (poetry, fiction, non-fiction, essay, novel, novella, monograph, etc.)
     Beginning     Emerging     Professional     None
ACADEMIC - (thesis, dissertation, research, evaluation, project papers, etc.)
     Beginning     Emerging     Professional     None
TECHNICAL - (reports, grant proposals, reference works, manuals, etc.)
     Beginning     Emerging     Professional     None
SPECIALTY - (journalism, play/film/TV scriptwriting, song/lyrics, etc.)
     Beginning     Emerging     Professional     None

Storytelling/Speaking Style and Experience

TRADITIONAL STORYTELLING
     Beginning     Emerging     Professional     None
CONTEMPORARY STORYTELLING
     Beginning     Emerging     Professional     None
READINGS/PERFORMANCE
     Beginning     Emerging     Professional     None
     LECTURES/SPEAKING
     Beginning     Emerging     Professional     None
     PRESENTATIONS/EXHIBITIONS
     Beginning     Emerging     Professional     None

Core Area Preferences

COMMUNITY CORE
Participate at a physical site in Wordcraft Circle gatherings, workshops, forums, seminars, etc.
Organize/conduct at a physical site a Wordcraft Circle gathering, workshop, forum, seminar, etc.
Organize/Conduct a Wordcraft Circle On-Line (Internet) writing workshop, chat-room, etc.

MENTORING CORE
Apprentice - work with an established Native writer/storyteller for at least one year ON-LINE (Internet/email).
Apprentice - work with an established Native writer/storyteller for at least one year OFF-LINE (mail/phone)

Mentor - work with a beginning/emerging Native/non-Native writer/storyteller ON-LINE (Internet/email).
Mentor - work with a beginning/emerging Native/non-Native writer/storyteller OFF-LINE (mail/phone).

PROFESSIONAL CORE
Available for book signings.
Available for speaking engagements.
Available to write reviews (books, essays, etc.)

Education

High School ________________________________________ Year Graduated ______
Location ________________________________________

College/University __________________________________
Location __________________________________________
Major _______________________________ Year Graduated __________ Degree ______

Honors & Awards

Please check the box if you are a Wordcraft Circle Honors and/or Awards Recipient.
Wordcraft Circle Honors/Awards Recipient.
Please state the honor and/or award (i.e., Wordcrafter of the Year) and the year received (i.e., 1996)

Please list other (non-Wordcraft) honors and awards you have received.

Published Writings
Please list your published writings
(Type [poetry/essay/short story/etc.], Title, Publisher, Date Published, ISBN/ISSN).

Public Storytellings/Speaking
Please list your public storytellings/speakings/readings/performances/lectures/presentations
(Type [storytelling etc.], host/sponsor, date of event, city/state]).

Biographical Profile
Please write a brief biographical profile.

Why Wordcraft Circle?
Please state why you are applying to become a member of Wordcraft Circle.
What will you be able to contribute toward expanding the Wordcraft Circle vision: to ensure that the voices of Native writers and storytellers -- past, present, and future -- are heard throughout the world?

Additional Documents

Your application will be processed when Wordcraft Circle receives:
- a recent photo of you
- a sample of your writings
- a check/money order for the dues amount.
Note: Credit card payments are not accepted at this time.

Please send check/money order (made payable to "Wordcraft Circle") to:

WORDCRAFT CIRCLE
c/o Dr. Kimberly Roppolo
Native American Studies Program
University of Oklahoma
633 Elm Avenue
Room 208
Norman OK 73019-3119 (or) WORDCRAFT CIRCLE
c/o Robert M. Nelson
2421 Birchwood Road
Richmond VA 23294

Click Here To Send Photo (.jpg file) And Writing Sample

Membership Agreement

By submitting this membership application, I agree to abide by the Bylaws and Code of Ethics of Wordcraft Circle of Native Writers and Storytellers.

Signature: ______________________________________

Updated: 10/05/2008

contact: Robert Nelson