Name of Business: ______________________________________________________
Business Address: ______________________________________________________
Name of Owner(s)______________________________________________________
Mailing Address: _______________________________________________________
Home Telephone: ________________Business Tel # ______________FAX #: _______
Email: __________________________ Website: ______________________________
Winter Mail Address: (list if applicable with dates that you are there)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
In accordance with MADA By-Laws, pleased be advised that an applicant must be in business for one year before applying for membership.
# of years in the antiques business? ______ What is your speciality? __________________
Types of stock, inventory? _________________________________________________
Do you sell any reproductions or new merchandise? ________ If so, please
state the percentage (%) of your inventory and the type of goods.
_____________________________________________________________________
Business Hours: _________Seasonal: _________Closed Days: _______ By Appt:______
List Shows that you exhibit at: _______________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
Page (2)
List (2) MADA Members that are familiar with your business?
Have they agreed to be a reference? __________________
#1.
#2.
List other professional organizations or associations of which you are a
member.
#1
#2
#3
#4
SIGNATURE: _________________________ DATE:_________________________
If you have a partner, add 2nd signature here: _________________________________
All applications must be accompanied by a non-refundable $10.00 application
fee. Annual dues will be billed upon acceptance. Make check payable to MADA.
Return application and $10.00 fee to:
Beverley J. Reynolds
352 Front Street, Bath, ME 04530
Tel# 207-443-8812: FAX: 207-443-2638
Email: bevyreynolds@gmail.com