Authors Marketing Group Membership Application

Membership Application

P.O. Box 6136

Woodridge, IL 60517

Please provide the following information for the AMG Membership Directory

(please type or print legibly):

Date:____________

Name: ________________________________________________________________

Mailing Address: ______________________________________________________________________

Telephone: ____________________ E-Mail Address:________________________

Website Address:______________________________________________________________

Name of Product(s), Publisher, Year Published:

¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾

________________________________________________________________

Website to order your products:______________________________________________

Here’s how I would like to contribute to AMG (check all that apply)

( ) speaker ( ) newsletter ( ) critiques/edits for others’ products

( ) website ( ) event planning ( ) programming

( ) membership committee

( ) other

¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾

Payment by check:
Please mail application with check to:
Authors Marketing Group

P.O. Box 6136

Woodridge, IL 60517

Payment by credit card:
Please complete the following and mail application to the address above

or fax to (888) 400-2706

Please add $2.50 for processing.

I authorize JAC Enterprise to charge my credit card in the amount of $32.50.

MasterCard ( ) Visa ( ) American Express ( ) Discover ( )

Card No.: ___________________________________ Expiration date: ____________

Security Code:____________ The three #’s on the back of your card.

Security Code:____________ American Express #'s are on the front of the card.

Address of cardholder:_____________________________________________________________

______________________________________________________________________

Card Holder's Name & Signature:

____________________________________________________

Questions? Call (708) 343-7715 or e-mail josslynchristmas@jacenterprise.com

For the website author page:

After your payment is sent, please email info@authorsmarketinggroup.org with

· a jpg of your product(s)

· a jpg of yourself

· synopsis About the Book, About the Author, Reviews, etc. for your page on the AMG website. (One page maximum please.)

· Keywords/meta tags (10 word maximum)