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Personal Information
I am a...(please check all that apply):
* First Name:
  Middle Name:
* Last Name:
Pen Name:
* Address(Street):
Address 2:
* City:
* State:
* Zip/Post Code:
* Home Phone:
digits ( ) space and '-' are allowed.
Cell Phone:
* Email Address:
* Date of Birth: Month: Day: Year:
Rep/Agency Name:
Rep/Agency Phone:
Rep/Agency Address:
Select Membership Level
Residents of Canada please note we will automatically add $10 to membership fee. Residents outside the U.S. and Canada we will add $20 to the membership fee.
Supporting materials
Please use the instructions below to include any supporting materials with your application.

1. a copy of a review or a program from a production of my work before a paying audience.
2. a copy of a published script by a legitimate widely recognized publisher.

1. a copy of a script
2. a program from a reading or workshop of my work.

1. a letter from my professor or advisor on University letterhead.

* Document:
You can upload files with the following extensions. pdf, doc, docx, xls, xlsx, jpg, jpeg, png, tif, tiff, gif
Make sure your file is under 7.5 MB.
Select a method of payment
* Card Number:
* Expiration Date: Month: Year:
* First Name on Credit Card:
* Last Name on Credit Card:
Required *