Individual Members

Account

Please enter a Username to create an account. If you already have an account please login before completing this form.

Username *

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Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores.

Member Profile

Please take a minute to review and update your contact details below.

Salutation

First Name *

Last Name *

Please share your pronouns if you feel comfortable to. We want to know how to respectfully refer to you.

Pronouns

Phone (Preferred) *

Email (Preferred) *

Street Address *

Suburb *

State *

Post Code *

Country

Do you wish to subscribe to our free fortnightly enews?

Enews preference

Yes No

How did you hear about us?

Writers Victoria members can choose to make some of their profile information available to other members.

Include in Directory?

Yes No

Please select any fields you do NOT want to be included in the directory listing.

Member Directory Options

If you were referred by a member, what is their name and/or email address?

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *