To become a full member, please provide the following information:

Name
E-mail Address
Full Postal Address
Phone Number
Medium/Genre of writing
Any other experience or interests

**NOTE**  You may choose to withhold your full address and phone number from the   
group’s database.  In that case, only the CITY and STATE would be listed but I still need the
information for the group records.  If you choose this option, please note it in your letter.  You
may also reserve this right for a later date.

Please send the above information, along with a check or money order for $10 (US) to the
address listed below.  I’m sorry, we're not able to take credit cards yet.  All checks/money
orders need to be made out to “Cameron Counts”.  Again, any participants of the screenwriting
contest will have this year’s dues waived.

Writing Initiative
P.O. Box 4699
Springfield,  IL
62708


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The Writing Initiative