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International Black Writers & Artists

P.O.BOX 43578

LOS ANGELES, CA 90043

323/964-3721 OR Ibwa_2000@yahoo.com

Http://members.tripod.com/ibwala/ibwa.htm

CONTACT US FOR INFORMATION REGARDING I.B.W.A.CONFERENCE SCHEDULED TO BE HELD FRIDAY EVENING AND ALL DAY SATURDAY - JULY 28 AND 29TH, 2000 (WE WILL NOTIFY YOU OF THE EXACT TIME IN THE COMING WEEKS) - IN COMMUNITY CONFERENCE MEETING AREA AT FOX HILL MALL, SECOND LEVEL, CULVER CITY, NEAR WIDE VARIETY OF SHOPS, RESTAURANTS AND HOTELS!

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IBWA CONFERENCE REGISTRATION AND MEMBERSHIP APPLICATION/RENEWALF0RM

Download and/or print out this form and send in with your

check or money order to address at top of this page.

CHECK ONE:

[ ] $25 MEMBER REGISTRATION FEE (DUE BEFORE MAY 25, 2000) IS ATTACHED.

[] $35 EARLY BIRD NON-MEMBER REGISTRATION FEE  IF PAID BY JUNE 10TH, 2000

[ ] $50 NON-MEMBER REGISTRATION FEE

(NOTE: BE PREPARED TO PAY FOR MEALS AT YOUR CHOICE OF RESTAURANTS OR CARRY OUT AT MODERATE PRICES, LOCATED IN OR NEAR THE MALL.

NAME (Please print) ________________________________________ Submitted: / /2000

ADDRESS:_____________________________________________________________________________________

CITY _________________________________STATE__________________________ZIP CODE ____________

PHONE NUMBER/AREA CODE: (_____)______________________________________________________

Fax:___________________________________Email:________________________________

Writing/Artistic specialty AND/OR area of interest: ___________________________

NOT A MEMBER? YOU MAY JOIN BY CHECKING APPROPRIATE BOX AND INCLUDING

MEMBERSHIP AMOUNT WITH YOUR REGISTRATION FEES FOR CONFERENCE

[ ] $45 General/Associate Member [ ] $75 Family (maximum of two members)

[ ] $30 Seniors and Students [ ] $20 Newsletter Only

[ ] $ ______ donation [ ] $95 Family or small organization

* *Dues and donations may be tax deductible