Print this form from your browser, fill it out and send to the address at the bottom of the form with your dues.
Your Name:
(First) _______________________________ ( Middle Init.) ____(Last)___________________________________________
Your Spouses or Family member in the business with you if you so desire it to appear in the directory:
(First) _______________________________ ( Middle Init.) ____(Last)___________________________________________
BUSINESS:
Name: ____________________________________________ (No. & Street or PO Box) ___________________________
(City)___________________________ (State or Prov.) ________ (Zip or Postal Code)_____________-_________
(Country )________________________Phone: (_____)___________________ FAX: (_____) ____________________
PERSONAL ADDRESS: (Street & No. or PO Box)
________________________________________________________(City)__________________________________________
(State or Prov.) ___________ (Zip or Postal Code)_____________-_________ (Country)_______________
Phone: (_______)___________________ FAX: (_______) _______________________
Email Address: _______________________________@_____________________________________
Website: http://www._____________________________________ Birthdate: (Mo)______(Day)_______ (YR)______
FULL TIME DEALER ___ PART TIME DEALER ___ (Please Check One)
NSDA Now requires its members to:
1. Be a member of good standing in the APS (American Philatelic Society) APS# ______________________
2. Hold a Current State Sales Tax License. Please give your local State: ________________ Retail Sales Tax Lisc.
# _______________________ If your from Oregon, or any state without sales taxes, please provide a license from another state which you do collect Sales Taxes. If you do not have a retail sales tax license provide a copy of your State, or Country business license.
If you have ever been expelled from a philatelic organization, please attach a separate letter of explanation to this application with details.
References: (Character References (NO relatives), two please. Stamp trade references if possible)
Name: _____________________________________________________ Phone No. (_________)___________________
Address: ___________________________________________________________________________________________
Name: _____________________________________________________ Phone No. (__________)___________________
Address: ___________________________________________________________________________________________
I hereby agree to the CODE OF ETHICS of the National Stamp Dealers Association, Its rules and regulations, and bylaws. Enclosed with this application are my dues per the graduated Dues Structure for the current year.
(US Currency only).
Signature of Applicant: __________________________________________________________
Referred by: __________________________________________________________ (NSDA? Yes/No?)____________
Please allow 4-6 weeks for processing. Application is subject to approval by the Board of Directors.
Send to: NSDA, 2916 NW Bucklin Hill Rd. #136, Silverdale, WA. 98383-8514
Phone: (800) 875-6633 Fax: 800 875-6633 Email: nsda@nsdainc.org
THANK YOU For your interest in our organization.