St. Louis Park Sportsmans Club

NEW MEMBER APPLICATION

NAME______PHONE #______-______-______

ADDRESS______CELL#______-______-______

CITY______STATE______ZIP______AGE______

MARRIED?______# OF DEPENDENTS______OCCUPATION/EMPLOYER______

EMAIL ADDRESS______

TYPE OF NRA MEMBERSHIP______NRA MEMBERSHIP NUMBER ______

NRA OR OTHER QUALIFICATIONS HELD: ______

PLEASE LIST ANY OTHER SPORTSMAN’S CLUBS OR ORGANIZATIONS IN WHICH YOU HOLD A MEMBERSHIP:

______

PLEASE CIRCLE CLUB ACTIVITIES ARE YOU INTERESTED IN:

TRAP - SKEET - RIFLE - ARCHERY - BLACK POWDER - PISTOL - CAMPING - SMALL BORE

PLEASE LIST TRADES OR TOOLS WHICH MAY BE USEFUL IN CLUB ACTIVITIES OR IN OUR RANGE

MAINTENANCE & IMPROVEMENT PROJECTS: ______

______

PLEASE CIRCLE CLUB AREAS YOU WOULD BE INTERESTED IN VOLUNTEERING TO HELP WITH:

YOUTH DAY - PUBLIC RIFLE SIGHT-INS - WORK DAYS - FIREARM SAFETY CLASSES - SCORE KEEPING - PICNICS

**IF YOU ARE NOT CURRENTLY A MEMBER OF THE NRA YOU WILL BE STONGLY ENCOURAGED TO JOIN.

IF ACCEPTED AS A MEMBER OF THIS ORGANIZATION I WILL AGREE TO ACCEPT THE RESPONSIBILITY TO COMPLY WITH THE BY-LAWS AND THE ESTABLISHED OPERATING RULES. I FURTHER PLEDGE TO PROMOTE THE GROWTH AND MAINTENANCE OF OUR RANGE FACILITIES BY FULFILLING MY WORK REQUIREMENT AS ESTABLISHED BY CLUB BY-LAWS.

Rev Feb 09 I CERTIFY THAT I AM A CITIZEN OF THE UNITED STATES; I AM NOT A MEMBER OF ANY ORGANIZATION WHICH HAS PROGRAMS THAT ATTEMPT TO OVERTHROW THE GOVERMENT OF THE UNITED STATES BY FORCE OR VIOLENCE; I HAVE NEVER BEEN CONVICTED OF ANY CRIME, I AM NOT MENTALLY DISABLED, OR HAVE OTHER RESTRICTIONS THAT WOULD PROHIBIT ME FROM OWNING, POSSESSING OR HANDLING FIREARMS AND THAT IF ADMITTED TO MEMBERSHIP, I WILL FULFILL THE OBLIGATIONS OF SPORTSMANSHIP AND GOOD CITIZENSHIP. OVER

*YOU ARE REQUIRED TO INCLUDE A PHOTO COPY OF YOUR MN PERMIT TO AQUIRE OR PERMIT TO CARRY WITH THIS APPLICATION.

**INCOMPLETE APPLICATIONS, SPONSORING MEMBER ISSUES OR FAILURE TO INCLUDE PHOTO COPY LISTED ABOVE WILL MAKE YOUR APPLICATION INVALID.

______(APPLICANT’S SIGNATURE)

SPONSORING MEMBER INFORMATION TO BE INCLUDED WITH YOUR APPLICATION:

SPONSOR’S NAME ______

SPONSOR’S ADDRESS ______

CITY ______STATE______ZIP______

PHONE #______-______-______CELL#______-______-______

SPONSOR’S SIGNATURE ______

SPONSOR MUST PROVIDE PROOF OF WORK CREDIT IF UNDER AGE OF 65

INSTRUCTIONS FOR APPLICANT:

(A) COMPLETE ALL SECTIONS OF APPLICATION.

(B) MAIL COMPLETED APPLICATION, PHOTOCOPY OF PERMIT TO CARRY OR PURCHASE AND A BUSINESS SIZE SASE TO THE MEMBERSHIP SECRETARY AT THE ADDRESS BELOW:

CATHY HAGEN MEMBERSHIP SECRETARY-ERSC 3546 JUNE AVE N ROBBINSDALE, MN 55422

(C) IF SELECTED AS A NEW MEMBER YOU WILL BE NOTIFIED OF THE DATE, TIME, AND LOCATION OF THE MEETING THAT YOU AND YOUR SPONSOR MUST ATTEND AND YOUR RANGE ORIENATION DATE BY MAIL IN MID FEBRUARY.

(D) APPLICATIONS MUST BE POSTMARKED NO LATER THAN JANUARY 24

(FOR MEMBERSHIP SECRETARY USE ONLY)

SPONSOR’S WORK CREDIT: YES______NO______SPONSOR’S DUES PAID: YES______NO______

Rev Feb 09 BACKGROUND CHECK: YES______NO______TYPE OF MEMBERSHIP: REG. SR. . ASSOC

DATE RECEIVED: ______/______/______

NOTES:______

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Rev Feb 09