Harlow
Practical
Club
Casual membership enquiry
New Member 'electronic' Application Form. |
| All Yellow
Questions MUST be answered |
| Name |
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| E Mail Address |
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| Phone Number |
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| Your Postal Address |
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| If less than one year, Previous address |
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| IF under 21 |
AGE
Date of birth |
| Occupation / Vocation |
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| Name & Address of
Employer |
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| Employers Telephone |
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| Years Service |
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| Position Held |
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| If less than one year, Previous employer's
Name & address |
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| Do you hold a firearm or
shotgun certificate? |
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| IF YES, Number & issuing authority. |
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| Have you ever been
refused a firearm or shotgun certificate, or held one and had it
revoked? |
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| IF YES, Please give reason. |
|
| Do you know of any
reason why you might be refused a firearm certificate? |
|
| IF YES, Please give reason. |
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| Have you previously applied
to join a rifle/pistol club? |
If YES what Date |
| Are you now, or ever
been a member of a rifle/pistol club? |
|
| IF YES, please give name & address of
club. |
|
| Do you know any members
of the Harlow Practical Club? |
|
| IF YES, Whom? |
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| Do you, now or in the
past, suffer any illness which might constitute a safety risk, e.g.
epilepsy, convulsions, mental illness, deafness? |
|
| IF YES, please give details of illness. |
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| Give names & addresses
of two references who may be contacted by the club |
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| I WISH TO
AT
AS A |
| What is your
MAIN shooting interest
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By clicking
'SEND FORM' I state that:
I am not prohibited from possessing a firearm or ammunition by virtue of
section 21 of the firearms act 1968 (as amended)
I certify that the above information is correct to the best of my
knowledge and if my application is accepted, agree to abide by the rules
& regulations of the club at all times. |
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