The Ohio Poetry Association
The Ohio Poetry Association - meets quarterly at 3510 N High Street - Columbus OH 43214 - Phone: (614) 268-5094
OPA EPaper Form - Click the Print Button Above!
EPaper form - Updated 11-15-08
THE OHIO POETRY ASSOCIATION APPLICATION
We welcome your addition to our growing family of poets and lovers of poetry. Thank you for taking the time to fill out this membership application. We would appreciate it, if you would type or print neatly.
What is your name (First, middle last) and mailing address and Email address? - Please Type or Print with a dark pen -
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First Name Middle Name Last name
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Street Address City State Zip Country
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Email Address
For which category of membership are you applying ?(Circle one)
Regular $18.00
Senior, Age 65 & older $15.00
Student (through college) $ 8.00
Associate – does not include Common Threads $ 8.00
Needs-based Scholarship (If you believe you fit this category, please contact us.)
(The information below is optional, but will allow us to provide you with better service.)
We may wish to call you from time to time. May we have your phone number(s)?
Home Phone:___________________ Work Phone____________________ Cell Phone ____________________
What is the best time to call you? ______________ am or pm?
May we include your name and contact information in a members directory?
(Circle one)? Yes No
We would like to get to know you better. Please tell us something about yourself and your writing experiences.
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Please use the back if need more room. Thank you!
How did you hear about The OPA?___________________________________________________________________
Why do you wish to join The OPA?___________________________________________________________________
How do you think you can best contribute to OPA? Are there specific areas you would like to volunteer, assist or help?__________________________________________________________________________________________
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With your completed application and your dues check or money order made payable to
THE OHIO POETRY ASSOCIATION (or OPA), you may submit up to three poems with your application and dues.
one or more of your poems may be included in our literary journal, Common Threads. All of these items
should be sent to:
David Francis Smith
OPA Membership Secretary and Treasurer
5580 Beverly Hills Drive - Apartment B
Columbus, Ohio 43213-6677
Email: david@ohiopoetryassn.org
Please visit our web site and join the members forum
http://www.ohiopoetryassn.org
Privacy Notice: The Ohio Poetry Association respects your right to privacy. A full online notice is available on the web site.
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