Application for membership
Full Legal Name, including middle name/s:
*
Title
First Name
Middle Name/s
Last Name
Any previous legal names by which you have been known:
Prefix
First Name
Middle Name/s
Last Name
Birth Date
*
Please select a day
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Date
Please select a month
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Month
Please select a year
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Year
Town and country of birth
*
Current Address
*
Street Address
Street Address Line 2
City
County
Post Code
Place of Birth
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Phone Number (preferred). If no area code type "n/a," if there is an extension type it in.
*
-
Area Code
Phone Number
Phone Number (alternate). If there is an extension type it in.
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Area Code
Phone Number
Email
*
example@example.com
Trade, Occupation, Profession:
*
Attach a passport-compliant photograph (in jpg format) with the file name “Surname, Initial and DOB (as DDMMYY)”, e.g. "Other A N 251299"
*
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Do you belong to a rifle / pistol / gun club?
*
Yes
No
If YES, please complete the following:
Specify:
Club name:
Date joined:
Club Secretary name:
Club Secretary contact e-mail address
Club Secretary contact tel. no.:
Type of membership (Full/Probationary)
Membership no:
Is this club your primary club, for the purposed of your FAC? (YES/NO)
How many times have you shot on ranges with this club in the past 12 months?
Other Rifle Clubs or Shooting Associations that you belong to + membership category description:
Over the past 12 months, on approximately how many occasions have you shot rifles at the following distances:
*
Specify:
25-100 m/y
100-600 m/y
> 600 m/y
Extra space if you have more to say about your current club(s)
Do you hold a FireArms Certificate?
*
Yes
No
IF YES
Specify:
Expiry date DD/MM/YYYY:
Issuing Force:
FAC Number
Do you hold a ShotGun Certificate?
*
Yes
No
IF YES
Specify:
Expiry date DD/MM/YYYY:
Issuing Force:
SGC Number
Are you now or have you ever been a member of the NRA:?
*
Yes
No
IF YES
Specify:
NRA Membership no.
Do you hold a Shooter Certification Card that has been issued by the NRA either: (1) via an NRA-affiliated Club of which you are a member, or (2) directly to you as a member of the NRA?
*
No
Yes, issued by NRA
Yes, issued by NRA-affiliated Club
IF YES (1 of 3)
Specify:
Expiry date DD/MM/YYYY:
State either "NRA" or the NRA Affiliated Club Name
State your "NRA Number" or NRA Affiliated Club Number
IF YES (2 of 3) Attach a photograph or PDF of your Shooter Certification Card with the file name “Surname Initial SCC Front”, e.g. "Other A N SCC Front"
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IF YES (3 of 3) Attach a photograph or PDF of your Shooter Certification Card with the file name “Surname Initial SCC Back”, e.g. "Other A N SCC Back"
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Have you had formal firearms training?
*
Yes
No
If yes, please give brief details of training or course(s) attended.
Applicants without civilian range experience will be required to attend a membership assessment and possibly attend a probationers’ course.
Attach copies of relevant training certificates/documentation.
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Do you suffer from any mental health or neurological conditions?
*
Yes
No
IF YES please describe:
For current and former military or Police personnel: Have you handled firearms in the course of your duty in the police or the armed services?
Yes
No
IF YES When did this activity and/or training cease?:
For current and former military or Police personnel: Can you provide a statement from your existing or former senior/commanding officer saying that you have been fully trained in handling the type of firearms in respect of which the Club has obtained approval and is able to use them safely without supervision?
Yes
No
Firearm ownership
Details of firearms currently held and intending to be used, whilst in Grove Small Arms Club ranges:
Please list firearms possessed or variations applied for (calibre and action/type of firearms) that you would like to use on the Club’s ranges:
Action/Type
Calibre
Action/Type
Calibre
#
#
#
#
#
Disciplines
Details of past/current shooting experience and of intended shooting disciplines, with the Grove or other clubs:
*
Current shooting activity/ies
Intended discipline/s @ Grove
Muzzle Loading Rifle / Pistol: Firearms that are loaded with components without a cartridge case
Classic Rifle Historic firearms such as the Lee Enfield No. 4
F Class a 'free' formula usually with Scope and bipod and a ½ minute of angle bull
Target (a.k.a. Practical) Shotgun: Multi-shot semi-automatic or manual target shotgun discipline
Mini Rifle: Dynamic shooting with .22LR self-loading rifle
Add any other current or intended shooting disciplines, with the Grove or other clubs:
Declarations:
This section must be fully completed, there is a text field at the end for any extra information you might like to share. Please note that disclosure of any information does not automatically exclude you from membership. However, failure to disclose such information may result in refusal or termination of membership.
*
FAC Holders only:
I certify that I am a current Full Member of the Home Office Approved Club listed on my FAC
Add any other information here
Sponsors and Referees
PLEASE NOTE: Members of the applicant’s immediate family, registered firearms dealers, serving police officers and police employees may not act as referees.
Referee 1 - Club sponsor or other Referee (must know you as a shooter and be able to state that you are a fit and suitable person to belong to a gun club). Please advise the Referee that we may make contact to discuss your application
*
Prefix
First Name
Middle Name
Last Name
Grove sponsor's membership number:
If your referee is a member of Grove Small Arms Club
How long have you known the Club Sponsor / Referee (minimum of 2 years) and in what capacity?
*
Club Sponsor / Referee Address
*
Street Address
Street Address Line 2
City
County
Post Code
Phone Number: If no area code type "n/a," if there is an extension type it in.
*
-
Area Code
Phone Number
Email
*
example@example.com
Referee No. 2 (must know you within a social environment and be in a position of responsibility). Please advise this Referee that we may make contact to discuss your application
*
Prefix
First Name
Middle Name
Last Name
Occupation:
*
Address
*
Street Address
Street Address Line 2
City
County
Post Code
Phone Number: If no area code type "n/a," if there is an extension type it in.
*
-
Area Code
Phone Number
Email
*
example@example.com
How long have you known Referee 2 (minimum of 2 years) and in what capacity?
*
Applicant's Signature
*
Date
*
/
Day
/
Month
Year
Date
If under 18, parent/guardian name
If under 18, parent/guardian signature
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