First name:

Last name:

Pen name:

Date of Birth:

City:

State:

Email:

Website:

Photo:

Choose your membership class: Select... Poeta Scriptor Socius Amicus

Please compose a brief bio fo yourself:

Explain why you write poetry:

What do you feel you can contribute to the familia:

What are you expectations upon joining the familia:

Please list your 5 favorite poets:

Please list your 5 favorite poems:

Please list your 5 favorite websites: