Millrock Writers Collective

Mailing List Request Form

To be added to the Millrock Writers Collective Mailing List
For more information, please fill out this form and
click the "EMAIL REQUEST" button.

As soon as your request is received, you will be placed on the mailing list.

Your Full Name:

Address 1:
Address 2/Apt:

     City:           State : Zip :
     Phone #1:    Phone #2:
   Fax #:

Email Address:

If you wish to be contacted select by which method you would like to be contacted:

Mail: Email: Telephone:

Your Comments, if any:

Note: If you prefer, you may print the completed form
and Fax it to:		845 255-3019
or Mail it to:		Millrock Writers Collective Post Office Box 563 New Paltz, NY 12561-0563

for more Information:		845 255-3019

Last updated: March 2, 2007