Membership Application Form

1
Full Name* This field is required.
Mr.
Mr.
Mrs.
Miss
Prefix
First Name
Middle Name
Last Name
2
Do you currently possess a firearms licence* This field is required.
YESNO
3
Have you received a Statement of Eligibly from QLD Police Weapons Branch?
YESNO
4
Date of Birth* This field is required.
Date
Day
Month
Year
5
Gender* This field is required.
Male
Female
Other
6
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Australia
Australia
Country
7
Postal Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Australia
Australia
Country
8
E-mail* This field is required.
example@example.com
Email Verified
Confirm Email
Email Verified
The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification
••••
Didn't receive verification code? orReceiving the email may take a few minutes, thank you for your patience!
9
Mobil Number* This field is required.
10
Home Number
11
Work Number
12
My Occupation is Occupation field. My Employer is Employer .
13
Membership Type
Adult Member
Adult Member
Junior Member (11-18 Years of Age)
Family / Spouse Member
14
Licences Held
Firearms Licence # (ABCDM)
Expiry Date (DD/MM/YYYY)
Concealable Licence # ( H )
Expiry Date (DD/MM/YYYY)
15
Affliations Held
Pistol Shooting Queensland Member # (PSQ)
Expiry Date (DD/MM/YYYY)
Sporting Shooters Australia (SSAA) Member #
Expiry Date (DD/MM/YYYY)
International Practical Shooting Confederation (IPSC)
Expiry Date (DD/MM/YYYY)
Shooter Union Membership #
Expiry Date (DD/MM/YYYY)
16
Have you ever been convicted of a criminal offence?* This field is required.
YESNO
17
Have you ever been refused membership of a Shooting Club?* This field is required.
YESNO
18
Have you ever been refused a concealable/firearm license?* This field is required.
YESNO
19
Are you a prohibited person as described in the Qld Weapons Act?* This field is required.
YESNO
20
*** Each applicant must, where applicable, provide (✓ tick box if attached):
Statement of Eligibility from Queensland Police Service.(QPol Form 0515) (If unlicensed).
Photocopy of any Licenses held. (Firearms ABCD M/Concealable H).
Copy of PSQ Card (if transferring from PSQ affiliated club).
Proof of identity (Photographic) e.g. Copy of Drivers License, Passport etc.
Two character references from persons the applicant has known for at least two years. (references to include referees name, address and contact phone number/email).
Declaration (Refer Over Page).regarding any current membership of another approved shooting club/s OR that you are not a current member of another approved shooting club.
Prospective member should arrange to attend a Club Committee meeting before membership application can be processed.
21
Upload your Identification(s) and supporting documents here* This field is required.
22
I the undersigned hereby make application to be admitted as a member of the Cairns Target Shooting Club Inc. I agree to be bound by the Memorandum and Articles of Association, Bylaws, Code of Conduct, Orders and Policies of the Club and to comply with the same at all times. I agree to make myself familiar with and abide by the provisions of Queensland Weapons Act and Weapons Regulations. I agree to maintain my PSQ affiliation as may be required by the club for handgun competition shooting. I agree to undergo such training and assessment as specified by the Club. Without explanation, the Cairns Target Shooting Club may decline membership of any applicant. Any person making a false or incomplete answer to any question on this application form may be disqualified from membership of this club.* This field is required.
YESNO
23
Members Proposing your Application. * This field is required.
Proposed by CTSC Member:
CTSC Member #:
Proposed by CTSC Member:
CTSC Member #:
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I Declare that* This field is required.Members of another club Declaration
I am a current member of another approved shooting club
I am not a current member of another approved shooting club
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If you selected "I am a current member of another approved shooting club" please supply club(s) NameClub or Club Name's
Club(s) Name
26
CTSC MEMBERSHIP APPLICATION DOCUMENTATION & DECLARATION* This field is required.It is a Weapons Licensing Act condition that the Cairns Target Shooting Club cannot accept a person for membership unless the person submits with their application for membership —(a) If the person does not already have a weapons licensee, a current statement of eligibility from Weapon’s Licensing (QPol Form 0515); and(b) 2 character references (including contact details) from persons the applicant has known for at least 2 years; and(c) A declaration (see below) that the person is or is not a current member of any other approved shooting club.CTSC MEMBERSHIP – YOUR RESPONSIBILITY TO NOTIFY CTSCNOTIFIABLE EVENTSIt is a legal responsibility that a CTSC member must notify the CTSC Committee immediately on the occurrence of any of the following events;a) You are/have been convicted of murder, manslaughter, armed robbery, unlawful wounding or grievous bodily harm; OR an offence involving drugs or weapons,b) You are/have been convicted of violence punishable by at least 7 years imprisonment;c) You are/have been;i. Convicted of, or discharged from custody on sentence after being convicted of, an offence relating to the misuse of drugs, the use or threatened use of violence,ii. Convicted of, the use, carriage, discharge or possession of a weapon,iii. Subject to a domestic violence order, other than a temporary protection order, oriv. Subject to an involuntary assessment order under the Mental Health Act 1974 or 2000 or similar order in another State,v. Refused a firearms license or had a firearms license revoked because you were not or were no longer a fit and proper person i.e.,d) You are subject to a temporary protection order;e) Prevented by an order of any court from holding a firearms license or possessing a weapon unless the order permits such under supervision;f) The holder of a suspended license;Any of the above make you an “excluded person” under Section 53, subsection (7) of the Weapons Act 1990.)I further declare that I have read, understood and truthfully answered all aspects of this application.
YESNO
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Signature* This field is required.
ClearPlease Sign Here
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Todays Date
Date
Day
Month
Year
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