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Please print and fill out this page. If this application prints on two
pages, complete both pages and mail to the address below.
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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. |
City __________________________ State __________ Zip + 4 _________________ |
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. |
Personal Reference ________________________________________________________ Address ___________________________________________________________________ Philatelic Reference ________________________________________________________ Address ___________________________________________________________________ Signature of Applicant _________________________________ Date _______________ Signature of Sponsor John R. Gordon USSS # 15027
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Remittance Schedule
| Amounts include dues, initiation fee and a subscription to the U.S. Specialist. Postage prepaid for USA addresses only; North America add $3.00, other countries $7.00 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: ___________ |
| revised 16-Nov-2000 |