NSW Training Nomination Form
Candidate Details
Name
*
Surname
*
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Postal address
*
SSAA Membership Number
*
SSAA Membership Expiry Date
*
-
Month
-
Day
Year
Date Picker Icon
NSW Firearms Licence Number
*
NSW Firearms Licence Number Expiry
*
-
Month
-
Day
Year
Date
Candidate's Full Name
*
First Name
Last Name
Candidate's Email Address
*
example@example.com
Candidate's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Candidate's Role/Position
*
Training Session Nominated For
Please Select
Holster Qualification Course (HQC) Instructor
Safe Shooting Instructor (Longarm)
Safe Shooting Instructor (Pistol)
Range Officer Instructor
Reason for Nomination / Supporting Comments
*
Endorsing SSAA NSW Branch/Affiliate Club
Branch/Club Name
*
Full name of nominator
*
SSAA Membership Number of Nominator
*
SSAA Membership Expiry Date of Nominator
*
-
Month
-
Day
Year
Date
Branch/Club position held
*
President
Senior Vice President
Junior Vice President
Secretary
Treasurer
Certification
*
Yes
No
Signature of nominator
Today's date
*
-
Month
-
Day
Year
Date
Course Nomination
Which course are you nominating the above candidate for?
*
Holster Qualification Course (HQC) Instructor
Safe Shooting Instructor (Longarm)
Safe Shooting Instructor (Pistol/Handgun)
Range Officer Instructor
Holster Qualification Course (HQC) Instructor
Candidate has continuously held a Category H NSW Firearms Licence for not less than 3 years
*
Yes
No
Candidate holds a recognised holster qualification
*
Yes
No
Holster qualification details
*
Candidate has demonstrated experience in holster use
*
Yes
No
NSW Firearms Licence categories held
*
Category A
Category B
Category C
Does the candidate agree to adhere to all relevant volunteer policies and Codes of Conduct?
*
Yes
No
Safe Shooting Instructor (Longarm)
Licence categories held
*
Category A
Category B
Continuous licence hold period
*
Less than 3 years
3 years or more
Does the candidate agree to adhere to all relevant volunteer policies and Codes of Conduct?
*
Yes
No
Safe Shooting Instructor (Pistol/Handgun)
Licence categories held
*
Category H
Category A
Category B
Continuous licence hold period
*
Less than 3 years
3 years or more
Does the candidate agree to adhere to all relevant volunteer policies and Codes of Conduct?
*
Yes
No
Range Officer Instructor
NSW Firearms Licence categories held
*
Longarm target categories (A and/or B)
Handgun target categories (Category H)
Longarms categories other than target — for sighting-in duties only
Candidate is an active SSAA NSW Range Officer
*
Yes
No
Length of time as an active SSAA NSW Range Officer
*
Less than 12 months
12 months or more
Endorsing entity
*
Branch
Club
SSAA NSW
NSW Firearms Licence categories held
*
Category A
Category B
Category C
Does the candidate agree to adhere to all relevant volunteer policies and Codes of Conduct?
*
Yes
No
Thank you for your interest in becoming an SSAA NSW Instructor. Based on your response, it appears you may not currently meet one or more of the eligibility criteria required for this nomination. Please review the relevant policy for the course you are applying for, or contact your Branch or Affiliate Club for further guidance before reapplying. If you believe this is an error, please contact SSAA NSW directly on 02 7900 1555.
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