$25

*All members of HODRW must maintain a current membership in RWA

Name __________________________________________________________________

Address ________________________________________________________________

_______________________________________________________________________

Phone Number ___________________ E-mail Address ____________________________

Please verify your current RWA number __________________

Are you a PAN member? _________ PAN associate? __________RWA Pro? ___________

If you are a PAN Member would you like to be contacted about a Personal Web Page on the HODRW Website?
_____________________

Do you have a website address? ______________________________________________

Do you want to be included on our HODRW E-mail loop? ___________

Are you interested in volunteering? ______________

What would you like most from this organization? __________________________________ ________________________________________________________________________

Do you wish to contribute to the HODRW scholarship fund? __________

Mail this form and your dues payable to:

HODRW
PO Box 3811
Englewood, CO 80155

or you may pay online using PayPal.  Simply cut and paste this filled out form and email to goldbooks2@aol.com and then go to paypal  to make your payment. It should be directed to treasurer@hodrw.com

Received _______________________ Check # _____________________