Membership Submission Form – Submissions

Please note:

Membership covers one year from payment date. Memberships will not automatically renew.
Required fields are marked by an * asterisk. Type “n.a.” for not applicable.
Online payments may be made from this page.
Payments by check still require submission of this form. Checks should be made payable to The Publishing Triangle, 511 Avenue of the Americas, #D36, New York, NY 10011.

Name(Required)

Individual or company name.

Name 2(Required)

Second individual in family membership.

Address Line 1(Required)

If company address, provide a contact person and/or department in line 1.

Address Line 2

If company, provide the company address in line 2.

City(Required)

State(Required)

Zip Code(Required)

Primary Phone(Required)

Secondary Phone

Email(Required)

Share Email?(Required)

From time to time the Publishing Triangle lends its mailing list to other worthy literary or LGBTQ groups. If you do not wish to be included in such mailings, please mark “No” below.

Yes

Membership Category(Required)

Please note: 1. Family or Individual members may change his/her/their associated mail address at any time, even if using a work address. The membership is tied to the person(s). 2. In business memberships, if the contact person (in address line 1, above) leaves the company, the membership remains with the company; it cannot be transferred to the person's home address. (Business membership is valuable for our Literary Awards programming.)

Individual ($40/yr: 1 person)

Business ($85/yr: 1 company)

Family ($70/year: 2 people/1 address; be sure to list both names above)

Payment Options(Required)

($40 USD per nomination; made payable to the Publishing Triangle.)

I will pay now.

I will send a check.

Individual Membership Fee

Price:

Business Membership Fee

Price:

Family Membership Fee

Price:

Total

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Individual Check Fee(Required)

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Business Check Fee(Required)

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Family Check Fee(Required)

Total Owed(Required)

After submitting form, please mail check payable to The Publishing Triangle, 511 Avenue of the Americas, #D36, New York, NY 10011.

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Check Received?(Required)

Yes

Name

This field is for validation purposes and should be left unchanged.