American Stamp Dealers Association, Inc.
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.
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