CONFEDERATE STAMP ALLIANCE
      MEMBERSHIP APPLICATION
 

Please feel free to print out this application, fill it out and mail with your dues payment to our Membership Chairman.


 

 

CONFEDERATE

STAMP ALLIANCE

APPLICATION

 

 

 

 

Please complete front and back of 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

______$28.00

 

______$14.00

 

Mar, Apr, May

_____$20.00

 

_____$11.00

 

Jun, Jul, Aug

______$16.00

 

______$ 9.00

 

Sep, Oct, Nov*

_____$30.00

 

_____$16.00

 

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

 

NOTE: Applicants residing outside the United States, Canada or Mexico MUST add $10.00 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.

 

(Continued below)

 

 

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   

11/06