SISTERS IN CRIME - MIDDLE TENNESSEE CHAPTER

http://www.sinc-midtn.org

Membership Form

(Circle one)

New   Renewal   Rejoining   Past Member

NAME: ( Ms. Mr. Mrs. Miss )__________________________________________________________

ADDRESS: __________________________________________________________________________

CITY:________________________________________ STATE:_______________ ZIP:______________

E-MAIL: ____________________________________________________________________________

PHONE:_____________________________________ FAX:___________________________________

Please Check

[ ] Published Mystery Writer

[ ] Unpublished Mystery Writer

[ ] Published in another Field

[ ] Editor

[ ] Agent

[ ] Publicist

[ ] Reviewer

[ ] Bookseller

[ ] Librarian

[ ] Reader

Local Chapter Annual Dues:                 $10.00      Paid_______________

National Chapter Annual Dues:            $40.00      Paid_______________

TOTAL PAID (circle one)  Check  Cash                         _______________

Make checks payable to: Sisters in Crime

Return this form with payment to:

Barbara Jernigan

SinC-Middle Tennessee

2925 Fernbrook Lane

Nashville, TN 37214