ESPER Membership Application Form

EBONY SOCIETY OF PHILATELIC EVENTS AND REFLECTIONS
Since 1988

ESPER Membership Application Form

This form may be filled in and submitted by clicking on the submit button
at the bottom of the page or it can be printed out and sent by regular mail
along with the membership fee.

Name:
Street Address:
Address continued:
City:
State/Provence:
Zip/Postal Code:
Country:
Home Phone:
Work Phone:
FAX:
Email address:
Date of Birth:
Sex:	Male Female

Your Collecting Experience:

Beginner
Intermediate
Advanced

Sponsor Name

Sponsor Number

Applying For:

New Membership Renewal

If applying for renewal
Previous Member Number

Applying for:

Adult Membership Junior Membership (Under 17)

If Applying for Junior Membership,
Your Age

Your Collecting Interests (Select any that apply):

African-Americans on World-Wide Stamps

African-Americans on U.S. Stamps

African-Americans on U.S. First Day Covers

African-Americans on U.S. Souvenir Pages

African-Americans on U.S. Ceremony Programs

African-Americans on U.S. Esoterica

Dr. Martin Luther King, Jr. - World-Wide

Collecting Areas Not Covered Above

Stamp Collecting Organizations You Belong To (Select any that apply):

APS (American Philatelic Society)

ATA (American Topical Association)

AFDCS (American First Day Cover Society)

ACPS (American Ceremony Program Society)

Organization/Organizations Not Listed Above

Philatelic Publications You Subscribe to (Select any that apply):

Linn's Stamp Weekly

Scott's Stamp Monthly

Stamps Magazine

Global Stamp News

Publication/Publications Not Listed Above