Membership Application
APPLICATION FOR MEMBERSHIP
I hereby apply for membership in the American Stamp Dealers Association, Inc. and agree, if accepted, to be bound by the Articles of Incorporation, Code of Conduct and Pledge of the Association, which I have received and with which I have familiarized myself. My check for dues and application fee is enclosed.
Name___________________________________________
(please print or type, membership is held in individual name)
Company Name, if any:___________________________________
Also Doing Business As___________________________________
(List Trade Names, Subsidiaries, etc.)
Partners or Stockholders:__________________________________
Business P.O. Box _______________________________________
City:______________________ State:_____ Zip Code :__________Years in Business:______ Established:________
E-Mail Address:_________________________________________
Website URL: __________________________________________
Business Tel ( )__________________
Business Fax ( )__________________
Business Street Address:__________________________________
City:______________________ State:_____ Zip Code :__________
___Publish ___Confidential______
Date of Birth____/____/____
(for insurance purposes)
Home Address__________________________________________
(For our records only)
I am applying for:
___ Provisional Membership
___ Regular Membership (must have two or more years Professional Philatelic experience)
___ The ASDA Chapter in my area (a copy of this application will be forwarded to them)
Sales Tax or Resale No._______________
Federal Employer I.D. No._______________
V.A.T. No.__________________
Years engaged in philatelic business:_____
Present Philatelic Memberships
_____________________________________________________
Former Philatelic Memberships and reason for termination
_____________________________________________________
Business Specialty (limit to 25 words) ________________________
_____________________________________________________
BUSINESS TYPE:
___ Retail
OPERATION TYPE:
___ Retail Store ___ Wholesale___ Mail Order
___ Publishing ___ Shows ___ Supplies ___ Auctions
References:
Bank________________________________________________
Address _____________________________________________
Account #_________________ Type of Account________________
Please list names and addresses of four trade references, philatelic only. Full address must be submitted. I authorize the ASDA to contact all references supplied.
1. _______________________________________________
2. _______________________________________________
3. _______________________________________________
4. _______________________________________________
5. _______________________________________________
Applicants from outside the United States must be members of their respective country's stamp dealers' organization, if such exists. Please state name of association and address.
Name____________________________________
Address__________________________________
ONE YEAR DUES PLUS APPLICATION FEE ENCLOSED
Submit two separate checks; one for dues and one for administration fee. All payments must be made in U.S. Funds, on a U.S. Bank.
___ Regular membership ($300.00)
___ Provision membership ($240.00)
___ Application Fee, non-refundable ($25.00)
___ Stationery and Advertising Enclosed
___ Proof of two years in business enclosed
___ Bank authorization enclosed
VISA/MasterCard/American Express accepted for full payment only.
Card #___________________________ Exp. Date_________
Name of sponsor, if any_______________________________
For your application to be complete, all of the above must be checked and the necessary materials supplied. Omission of any of this will only cause delay in the processing of your application.
Signature of Applicant________________________________
NOTE:
The By-Laws of the American Stamp Dealers Association require that the name of an applicant for membership be published in our official publication for at least thirty days, that all references be checked, and that the completed application then be forwarded to the Membership Committee for review and recommendation to the Board of Directors at its next scheduled meeting. This procedure can take from two to four months depending upon the date of issue of our next publication, the speed with which references reply, and the date of the next Board of Directors meeting.
If an individual is expelled from the Association, the expulsion will be published in ASDA's official publication as well as the philatelic press. Any and all information contained in this application becomes the property of ASDA and may be used by the Association and its duly authorized agents for whatever purposes it deems appropriate.
Mail with your payment to:
AMERICAN STAMP DEALERS ASSOCIATION, INC.
3 School Street
Glen Cove NY 11542