American Philatelic Society

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Names of Adults Attending:
Names of Children Attending:
Email Address:
Address Line 1:
Address Line 2:
Zip Code/Postal Code:
Is any member of your household a member of the American Philatelic Society?
      YES       NO
       If YES, provide APS number if known
Are you a stamp collector, or do you have an interest in collecting?
      YES       NO
Would you be interested in joining a stamp club to help you with the hobby?
      YES       NO
Where will you stay during the show?
      Home    With Friends or relatives    Hotel/Motel/B&B    Other
How did you travel to this show? (If by car, how many miles?)
      Car    Air    Bus    Train    Other
      <50 mi.    51-99 mi.    100-199 mi.    200-499 mi.    500+mi.

How did you hear about the show?

Billboard     Newspaper Stamp Dealer  
Friend     Postcard/Poster Stamp Publication    
Internet     Radio    American Philatelic Soc.    
Magazine      Stamp Club     Other        
I/We plan to attend:
      1 day     2 days     3 days    
Tell us about yourselves.

      Total:          # Adults           # Youth

      Gender:       # Males           # Females

      Ages:    <12     13-25     26-49     50-65     66+
I would like to help at the show. Please contact me about volunteer opportunities.
See details about volunteering
      YES       NO
       If you are volunteering and would prefer to be contacted by phone,
       please provide a daytime phone number
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