Bookstore Membership Renewal

Bookstores: Renew Your Membership

Thank you for your continued participation in our association of independent bookstores. We believe we are stronger together. Please fill out the form below to renew your membership.
Bookstore Name *
Your Name *
Your Email *
example@example.com
Before proceeding, please check our member database to make sure we have up-to-date information for your store.
Do we have the correct store address on file?

Yes No, I have a different store address My store does not have one permanent physical location
Store Address
Street Address
Street Address Line 2
City
State
Zip Code
Do we have the correct store phone number in our database? *

Yes No
Bookstore Phone Number

Area Code Phone Number
Are you the primary contact for your store? *

Yes No
Primary Contact
Primary Contact E-mail
Primary contact role at bookstore

Owner Manager
Primary Mailing Address *

Same as bookstore address Different than bookstore address
Mailing Address
Street Address
Street Address Line 2
City
State
Zip Code
If you have a new store logo, please upload it here.

Browse Files

Cancel of
New or Used Books: What does your store sell? *

New Books Only Used Books Only Both New & Used Books
Bookstore Roadmap Art

Signing up for MIBA membership automatically adds your store to the Midwest Indie Bookstore Roadmap, you don't have to do anything else. Please use the area below to describe any changes to your store that should be reflected in your store art.
Has your store changed since the last roadmap? Please describe here.
Do we have the correct website and social media URLs for your store? *

Yes No
Store Website URL
Store Twitter URL
Store Facebook URL
Store Instagram URL
Do you own additional bookstores? If so, please list the names and addresses here. We will follow up with you for details.
Is your store currently a member of the American Booksellers Association? (Membership in ABA is not required for MIBA membership.)

Yes No
Does your store report sales to the ABA (with Bookscan, ABA manual entry, or ABA file upload)?

Yes No

Additional Staff
Provide the names, titles, and emails of anyone on your staff that you would like to receive correspondence from our association. This form has room for up to 5 additional staff. If you would like to add more than this, please contact Kate Scott at kate@midwestbooksellers.org.
Name 1
Email 1
example@example.com
Title / Role 1

Owner Co-Owner Bookseller Event Coordinator Book Buyer Manager Marketing
Bookstore 1

Additional Staff 2
Name 2
Email 2
example@example.com
Title / Role 2

Owner Co-Owner Bookseller Event Coordinator Book Buyer Manager Marketing
Bookstore 2

Additional Staff 3
Name 3
Email 3
example@example.com
Title / Role 3

Owner Co-Owner Bookseller Event Coordinator Book Buyer Manager Marketing
Bookstore 3

Additional Staff 4
Name 4
Email 4
example@example.com
Title / Role 4

Owner Co-Owner Bookseller Event Coordinator Book Buyer Manager Marketing
Bookstore 4

Additional Staff 5
Name 5
Email 5
example@example.com
Title / Role 5

Owner Co-Owner Bookseller Event Coordinator Book Buyer Manager Marketing
Bookstore 5

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Additional Updates: Please let us know any store updates that weren't covered in this form.
Please let us know if you have suggestions for things MIBA could be doing more of for bookstore members.
New vs. Renewal

New Renewal

Payment

MIBA Bookstore Membership ( $ 150.00 one-time payment)

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

Should be Empty:

Bookstores: Renew Your Membership