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MEMBERSHIP CHANGE FORM
FOR NAME, ADDRESS, TELEPHONE
and other changes to your membership previously submitted
THIS FORM IS FOR MEMBERS ONLY MAKING CHANGES TO
THEIR WSA MEMBERSHIP INFORMATION CURRENTLY ON RECORD.
MEMBERS ONLY Please enter your new information below. In the comments section, please include former name, address etc., that you were listed under, in order to have us update your file correctly. Membership info is published twice yearly. Deadlines for changes are December 1 (for February Show) and June 1 (for August Show).
First Name:
Last Name:
Company:
Address:
Suite/Floor:
City:
State:
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Country:
Tel:
Fax:
Check here if your name changed
Check here if new address
Check here if new Tel/ Fax/ e-mail
Check here for all others
Your e-mail address:
CHANGES TO DIRECTORY LISTING:
Please indicate below changes to your directory listing and specify if you are adding/replacing the listing currently on file.
Adding
(to current listing)
Replacing
(delete old info-insert new info)
Company
or
Brand Name:
Address:
Suite
:
City:
State:
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Country:
Website:
Tel:
Fax:
Product:
Men's
Women's
Children
Handbags
Accessories
Shoe Care
Other:
Additional Directory Listing Change:
Adding
(to current listing)
Replacing
(delete old info-insert new info)
Company
or
Brand Name:
Address:
Suite
:
City:
State:
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Country:
Website:
Tel:
Fax:
Product:
Men's
Women's
Children
Handbags
Accessories
Shoe Care
Other:
Additional Directory Listing Change:
Adding
(to current listing)
Replacing
(delete old info-ins
Company
or
Brand Name:
Address:
Suite
:
City:
State:
Select
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Country:
Website:
Tel:
Fax:
Product:
Men's
Women's
Children
Handbags
Accessories
Shoe Care
Other:
Please enter additional info and comments below.
Comments:
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