Persephone Membership Form  

 
Please highlight the fields below and use your browser's "copy" function, then hit the "SUBMIT" button and paste the questions in the body of the e-mail with your answers. Thank you.

Name

Address

State/Province

Zip/Postal Code

Phone Number(s)

Email Address

Alternate Email Address

Website URL

Publication Credits (title, publisher, year):
For short fiction/nonfiction, please supply pay rate per word.
For book length: advance (yes/no), royalties (yes/no), returnable (yes/no).
For poetry, please supply pay rate per poem or collection.
For full-length scripts, conditions of sale.

Other info

Agent

Agency Name

Agent's Email Address