Fillable MEMBERSHIP APPLICATION - RETAIL FIRM

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MEMBERSHIP APPLICATION - RETAIL FIRM

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The MEMBERSHIP APPLICATION - RETAIL FIRM form is 2 pages long and contains:

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  • 8 check-boxes
  • 66 other fields

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File type: PDF

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MEMBERSHIP APPLICATION - RETAIL FIRM
Name: Corporate Name:
Firm Location: Business District Residential Area Shopping Center
Street Address:
City:
State: Zip:
Phone:
Fax:
E-mail: Web Address:
Primary Contact Name:
Primary Contact Phone: Primary Contact Email:
Name of Sole Owner(s): Active: Yes No
Name of Principals/Ocers:
Name: Title: Active: Yes No
Name: Title: Active: Yes No
Date of Incorporation: Number of Employees: Full-time: Part-time:
How did you hear about the American Gem Society?
Are you a client of AGS Laboratories? Yes No
Do you own any other jewelry stores in the same city or other cities? Yes No
• If yes, list additional location addresses and number of employees on a separate sheet.
Do you operate a wholesale, loan or pawn business out of your retail operation? Yes No Percentage:
Does your rm possess a binocular gem microscope? Yes No
• I understand that if “No” has been indicated above, our rm will be required to purchase a binocular gem microscope upon election.
Initials of Firm Principal:
American Gem Society
®
Titleholder Application
In order to best protect the consumer through knowledge and ethics, and maintain membership of the rm, each American Gem Society
Retail Firm member must have at least one individual, either the principal or a full-time employee, satisfy the requirements for the Registered
Jeweler (RJ) title. e individual must have completed, or be enrolled in, the Applied Jewelry Professional (AJP) program and the 5-day
Diamond Grading Laboratory or 5-day Gem Identication Laboratory through GIA, or equivalent education through Gem-A or other
approved institutions. Following the prerequisite education, the individual must successfully complete the AGS Way course to earn the
RJ title. is individual has two years from the date of election to complete the required studies to receive their title. Please complete
the following for the full-time employee who will become an American Gem Society titleholder:
Applicant Name:
Street Address: City: State: Zip:
Phone: E-mail:
Please list the gemological courses completed, and please be sure to include the dates. If these were GIA courses, please provide
student number:
GIA Student #:
Courses Completed:
MEMBERSHIP APPLICATION - RETAIL FIRM
Please complete the following sections and/or provide the necessary documentation in order to complete your membership application:
Diamonds and precious gemstones Approx.____%
(including mounted or loose gemstones and cultured pearl jewelry)
Karat gold jewelry Approx.____%
Costume and fashion jewelry Approx.____%
Watches Approx.____%
Silver, silver-plate, stainless steel Approx.____%
China and crystal Approx.____%
Repairing and engraving Approx.____%
Appraisals Approx.____%
All other departments Approx.____%
(if greater than 10%, explain on a separate sheet)
Merchandise: Indicate the percentage of sales to total business volume.
Photos: Photographs of the interior and exterior of your rm (and branches if applicable), and a photo of your binocular
gem microscope (if you possess one).
Appraisal: Sample of a completed appraisal, if applicable.
Letter Describing Your Business: Please write one to two paragraphs on your company stationary describing your business
policies and standards, and why you wish to join the American Gem Society.
Letters of Recommendation: Retail Firm members must submit three (3) letters of recommendation from active American Gem
Society members with at least one (1) letter from a Retail Firm member. Please list the members we can contact on your behalf to assist
in collecting these letters.
Consumer Protection: Has your rm ever had a case before the Better Business Bureau, Federal Trade Commission, Jewelers
Vigilance Committee or other such municipal, county or state consumer protection agencies? Yes No
• If yes, please submit information on a separate sheet.
Jewelers Board of Trade (JBT) Report: I understand that the American Gem Society can request a Jewelers Board of Trade (JBT) report
about our rm. If not listed with JBT, a credit report and/or credit references will be provided by our rm. Members of the American Gem
Society must comply with United Nations Resolutions to purchase diamonds from legitimate sources not involved in funding conict.
Initials of Firm Principal: ___________
Total Gross Business Volume: For all locations during the last scal year (12 months) (for dues billing purposes only).
Payment Option: Please select the payment plan for your rm below. To learn more about the payments available in each plan, please
contact the Membership Department.
6-Installment 12-Installment Pay-in-Full
Please note there is a $2.50 fee per installment.
I hereby certify that the above statements and information are complete, true and accurate and understand that the correctness of the
accuracy of the above statements and information and verication of the same are to be construed as a condition of precedent to
membership. I authorize an investigation of the credit report of the above rm and of the above statements and information and
authorize the release of information concerning damages or liabilities which might result from issuance of a credit report or from the
verication or attempted verication of the above information and statements. If elected to membership, I agree to abide by the Articles
of Incorporation, Standards and Bylaws of the American Gem Society.
Firm Principal Signature: Date:
I give the American Gem Society permission to share the email address on this application with other American Gem Society members.
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MEMBERSHIP APPLICATION - RETAIL FIRM

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Completed 8 December 2021

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