Membership Application Form

NEWARK & DISTRICT WILDFOWLERS ASSOCIATION

AFFILIATED TO B.A.S.C & B.F.S.S. FOUNDED 1964
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Post-code
E-mail*
example@example.com
Mobile Number

Area CodePhone Number
Home Number

Area CodePhone Number
Have you been prosecuted for any infringement of Firearms/Game Laws?*
Are you currently a member of B.A.S.C.?
B.A.S.C. membership No. blanks
Are you a member of any other shooting organisation/club? blanks
How long have you been shooting? blanks
What type of shooting are you interested in? blanks
Do you already have access to shooting? blanks
If accepted for membership are you prepared to participate regularly in club activities?
If accepted membership I agree to abide by the Club rules.
Date of Signature*

DayMonthYear
Date
Please upload a passport style photo of yourself. Photo must be clear, in colour and of good quality.
Signature*

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NEWARK & DISTRICT WILDFOWLERS ASSOCIATION