ASDA 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 By-Laws, code of Conduct and Pledge of the Association, which I have familiarized myself.

Name:__________________________________________________________________

Company Name (if any):____________________________________________________

Also Doing Business As:____________________________________________________

Partners and/or Stockholders:________________________________________________

Business Mailing Address:__________________________________________________

Business Location:________________________________________________________

Publish or Confidential

Business Telephone:_______________________Business Fax:____________________

Year BusinessEstablished:__________________ Date of Birth:____________________

Email Address:____________________________Website:_______________________ 

Home Address (for our records only)_________________________________________

Sales Tax or Resale No:_____________________ Federal I.D. No:_________________

V.A.T. No:________________________________

Present Philatelic Memberships:_____________________________________________

Former Philatelic Memberships and reason for termination:_______________________

_______________________________________________________________________

Business Specialty:_______________________________________________________

Business Type:   Retail     Wholesale     Publishing     Supplies

Operation Type:     Retail     Store     Mail Order     Shows     Auctions

References

Bank:__________________________________________________________________

Address:________________________________________________________________

Phone #:________________________________________________________________

Account #:_______________________________________________________________

Type of Account:__________________________________________________________

List the names and addresses of four philatelic trade references. I authorize the ASDA to contact all references supplied.

 
1. ______________________________________________________________________

2. ______________________________________________________________________

3. ______________________________________________________________________

4.______________________________________________________________________

Applicants from outside the United States must be members of their respective country’s association/society if such exists. Please state name and address.

Name:____________________________________________________________________

Address:__________________________________________________________________

One Year Dues Plus Application Fee Must Be Enclosed

 
Applying for Provisional Membership – Less than two years professional philatelic experience

Applying for Regular Membership – Must have two of more years professional philatelic experience

Do you wish to apply to the ASDA Chapter in your area?     Yes      No   
A copy of the application will be forwarded

Regular Member $300

Provisional Membership $240.00

Application Fee  (Non-refundable) $25.00

Payment must be made in U.S. funds drawn on a U.S. bank.

American Express, Visa, MasterCard, Discover

Card # ________________________________Exp. Date__________________________

Print or type the name of your sponsor, if any:___________________________________

For your application to be complete, all of the above material must be enclosed. Omission will cause delay in the processing of your application.

Signature of Applicant:____________________________________Date:_____________

Note: the By-Laws of the Association require that the name of an applicant be published, that all references be checked, and that the 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 up to four months, depending on the date of publication, the speed with which references reply, and the date of the next Board of Directors meeting.

In an individual is expelled from the Association, the expulsion will be published in the 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 to:

American Stamp Dealers Association, Inc.
PO Box 672
Leesport PA 19533