MEMBERSHIP APPLICATION

Please feel free to print out this application, fill it out and mail with your dues payment to our Membership Chairman. A PDF Version of this application is also available.


 

CONFEDERATE

STAMP ALLIANCE

APPLICATION

 

Please complete form and mail to:

 

       Col. Larry Baum

        316 W Calhoun St.

        Sumter, S. C. 29150                                                                                 DATE:___________________

 

I hereby submit my application in the Confederate Stamp Alliance. If elected to membership, I agree to be bound by the Constitution and By-Laws of the Alliance. Membership includes a subscription to The Confederate Philatelist, published quarterly.

 

 

NAME:___________________________________

 

 

ADDRESS:________________________________

 

 

CITY:__________________  STATE: __________

 

  

ZIP:____________ COUNTRY:_______________

 

 

EMAIL ADDRESS:________________________

 

 

OCCUPATION:___________________________

 

 

Home Phone:_____________Work:____________

 

 

CSA Collecting Interests:_____________________

 

Under 18?       ______YES  _____ NO

 

 

Collector?       ______YES ______ NO

 

 

Dealer?           ______YES ______ NO

 

 

Other Philatelic Memberships:

 

APS # __________USSS # __________

 

 

USPCS #________ASDA # _________

 

 

OTHERS:________________________

 

 

Previous CSA Member:        ___YES ___NO  

 

If yes,  previous Member #______

Mailing addresses of new Members are published in The Confederate Philatelist as required by our By-Laws. If you do not wish to have your Email address published, please check here.  ______

 

PLEASE ALLOW 4 6 WEEKS FOR THE APPLICATION TO BE PROCESSED. PLEASE REMIT AMOUNT INDICATED BY THE DUES SCHEDULE WITH YOUR APPLICATION.

 

 

 

 

Active (age 18 and over)

 

Junior (under age 18)

 

Dec, Jan, Feb

 

______$32.00

 

______$18.00

 

Mar, Apr, May

 

_____$24.00

 

_____$15.00

 

Jun, Jul, Aug

 

______$20.00

 

______$13.00

 

Sep, Oct, Nov*

 

_____$34.00

 

_____$20.00

* Last quarter application fee includes dues for the following year.

 

NOTE: Applicants residing outside the United States, Canada or Mexico MUST add $24.00 to the application schedule.  PAYMENT MUST BE IN U. S. FUNDS DRAWN ON A U. S. BANK OR INTERNATIONAL MONEY ORDER, made payable to the Confederate Stamp Alliance.

 

 


REFERENCES:

Each applicant MUST provide character references below. Full names, addresses and numbers should be given as all references will be contacted as required by our By-Laws. If the application is for a Junior Member, the GUARANTOR must provide references.

Name and address of TWO character references (philatelic preferred, but not required):

NAME:________________________________

ADDRESS:_____________________________

CITY:__________________STATE:_________

ZIP:___________COUNTRY:______________

 

 

EMAIL:___________________

Home Phone: _______________

Work Phone:________________

 

 

NAME:________________________________

ADDRESS:_____________________________

CITY:__________________STATE:_________

ZIP:___________COUNTRY:______________

EMAIL:____________________

Home Phone: _______________

Work Phone:________________

 

If applicant is under age 18, please provide name and address of Guarantor:

 

NAME:________________________________

ADDRESS:_____________________________

CITY:__________________STATE:_________

ZIP:___________COUNTRY:______________

EMAIL:____________________

Home Phone: _______________

Work Phone:________________

Relation To Applicant:__________

 

Guarantor shall be responsible for all debts incurred by Applicant to the Alliance or any of its members until Applicant reaches eighteen years of age.

 

I agree to the conditions stated on this application and authorize the above-stated parties to release financial or character reference information on myself to the Confederate Stamp Alliance.

Signature of Applicant:_________________________________________________

Signature of Guarantor (if applicable):____________________________________

I hereby endorse the above Applicant and propose for membership in the Confederate Stamp Alliance (Proposer must not be one of the references above).

Proposed by:________________________________________ CSA # __________

VISIT OUR WEBSITE AT CSALLIANCE.ORG

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