Mail to:	Col Larry Baum	                  	Date: _________________
		316 West Calhoun Street
		Sumter SC 29150

I hereby submit my application for membership in the Confederate Stamp Alliance. If elected to membership I agree to be bound by the Constitution and By-Laws of the Alliance. I enclose the amount indicated below. This amount includes a non refundable processing fee of $2.00 plus dues for the balance of the fiscal year. One half of the dues is for a subscription to the Confederate Philatelist to start with the current or next issue as appropriate. PLEASE PRINT

Name..............................................................................................................
Street (Box) Address.......................................................................................
City.................................................................................................................
State..................................Zip......................... Tel:.............................. E-Mail:.................................... Occupation.......................................................Collector?..........Dealer?..............
Have you previously been a CSA member? Yes No Former Member #.....................
Membership in other philatelic societies................................................................

Mailing addresses of new members are published in the Confederate Philatelist as required by our By-Laws. Remit amount indicated for application submitted in

NOTE -- Applicants residing outside of the United States, Canada or Mexico MUST add $10.00 to the applicable schedule. All payments must be in USA Funds and drawn on a USA Bank or International Money Order.

REFERENCES -- Each applicant MUST give two references as to his/her character by completing the items listed below (philatelic preferred but not required). Full names and addresses must be given as all references will be contacted as required by our By-Laws. Please Print

Name.....................................................................................................
Street (Box) Address..............................................................................
City........................................State.......... Zip.....................Tel:............................E-Mail............................

Name.....................................................................................................
Street (Box) Address..............................................................................
City........................................State.......... Zip.....................Tel:............................E-Mail............................

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

Signature of Applicant...................................................................................