United States Stamp Society
Application for Membership
Mail to: Executive Secretary, P.O. Box 6634, Katy, TX 77491-6634
| I hereby apply for membership in the United States Stamp Society
and have enclosed payment for my initiation fee, dues and a subscription
to The United States Specialist based on the remittance schedule
below. I understand that the full amount of my remittance will be returned
to me if my application is not accepted. |
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Name ____________________________________ |
Date of Birth __________________
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Address _______________________________________________________________________
City __________________________
State __________
Zip + 4 _________________
Email _______________________________________________________________________
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References
Note: References are not required of current members of the American
Philatelic Society or the American Stamp Dealers Association. Only a membership
number is needed. Others should provide a full name and address of a personal
and a philatelic reference.
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| APS No. ____________ |
ASDA No. ____________ |
Personal Reference ________________________________________________________
Address ___________________________________________________________________
Philatelic Reference ________________________________________________________
Address ___________________________________________________________________
Signature of Applicant _________________________________
Date _______________
Signature of Sponsor* _________________________________
USSS # _______________
* If requested, the Executive Secretary may at his option sign as your sponsor.
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Remittance Schedule
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Amounts include dues, initiation fee and a subscription to the U.S. Specialist. Postage
prepaid for USA addresses only; North America
add $8.00, other countries $30.00 in U.S. funds. Make checks payable to the U.S.S.S.
|
Jan-Feb-Mar
Apr-May-June
July-Aug-Sept
Oct-Nov-Dec |
$25.00
$20.00
$15.00
$30.00* |
Amount Enclosed: ___________
|
*Includes 12 months of the following year.
revised 08-Nov-2007
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