Store Application

• MEMBER STORE APPLICATION •

For membership categories, eligibility, and benefits, please visit our website: www.episcopalbooksellers.org/categories-benefits/

Store Membership Dues are $125 per year.

Store Membership:

Annual dues of $125

Contact Information

Store Name*

Manager's Name*

First NameLast Name

Street Address (do not use PO Box)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Area CodePhone Number

Fax Number*

Area CodePhone Number

E-mail*

Website

The store is owned by (or incorporated as)

EIN# (Federal ID#)

State Resale License #*

in the State of*

Website Information

Do you have a website for your store?*

YesNo

Does your website have shopping cart (e-commerce) features?

YesNo

Staff Information

How many of your staff members are paid?*

Full-time?

Part-time?

Do volunteers help staff your store?*

YesNo

Membership Fees

Membership fees are due with application. Membership in Episcopal Booksellers Association is for calendar year from January 1 - December 31. Memberships renewed during the year are through December 31 as well.

If you wish to pay by CHECK, submit your form with no payment and make your check payable to: Episcopal Booksellers Association.

Please mail check to:
Episcopal Booksellers Association
PO Box 58132
Fayetteville, NC 28305

You may also pay your membership fee by CREDIT CARD. If you would like to pay by credit card, use the form below.

Credit Card Payment

USDMembership in EBA

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Thank you for joining Episcopal Booksellers Association. Your password for the "Members Only" section will be emailed to you along with instructions on how to use our Member Email List Service.