1. Please fill in all sections under Directory Information.
2. Be sure to provide all the information requested under General Information.
3. Send the completed form by clicking the Submit button below.

You must be actively engaged in the buying and selling of antiquarian books for at least one year to be eligible for FABA membership.

Please be advised: Because of the large size of our state, FABA Board of Directors meets infrequently — usually no more than twice a year. Therefore, it may be several months between the time you send in your application and your final notification of the board's decision. Feel free to contact the vice president for an update on your application.

As part of the review process of your application, a board member will be required to come and view your inventory. For open shops, obviously this poses little difficulty, but for those of you who deal as "mail only" dealers, some arrangement will have to be made so that a board member can review your stock. There can be no exceptions to this requirement.

DIRECTORY INFORMATION (Please limit your entry to 45 characters per line. Text may be edited for directory printing.) * Required City or metro area for directory listing: * Business Name: * Your Name: * Street Address P.O. Box * Business City * Zip * Telephone: Email: Web site: General stock or subject specialties: * Sidelines and services: Number of hardbacks: * Number of paperbacks: * Number of other items: *     Do you accept credit cards? Yes    No If so, which ones? Please click all that apply. Visa/MasterCard     American Express Discover Other     General Information Please provide the names of two FABA references: a. The names of individuals agreeing to be your references and shop names are required. b. If you have recently relocated to Florida, the names of two out-of-state dealers agreeing to be your references, with shop names and telephone numbers, are acceptable. Reference 1 name: * Reference 1 shop name: * Reference 1 telephone: *     Reference 2 name: * Reference 2 shop name: * Reference 2 telephone: *     When did you establish or acquire your antiquarian book business?: *     Have you ever been convicted of a crime? YesNo If you have ever been convicted of a crime, please explain in detail.:     Have you ever filed for bankruptcy or been adjudged bankrupt? Yes No If you have ever filed for bankruptcy or been adjudged bankrupt, please explain in detail.:     What is the form of your corporation? Sole proprietorship Partnership   Corporation Other If Other, please explain: Please list all persons who have a proprietary interest in your business.: *Name: *Street Address: *City *State: *Zip code: *Telephone:     **Name: **Street Address: **City: **State: **Zip code: **Telephone:     Please submit a bank reference. Name of bank: * Bank Address: * Bank City: * Bank State: * Bank Zip code: * Please submit by mail or email a copy of your Florida Resale Certificate Number   I affirm that the above information is true, that I have read and will abide by the FABA Bylaws and Code of Ethics, and that I am qualified for membership in the FABA. (Please type your name in the space provided.) * Security Code: *