WILKES-BARRE RIFLE & PISTOL CLUB APPLICATION FOR MEMBERSHIP INSTRUCTIONS

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APPLICATION FOR MEMBERSHIP INSTRUCTIONS 1. Print all info requested. If the information cannot be read, the application will be disapproved. Include area codes with phone numbers and complete addresses. If the information requested in a section is non-applicable to you, indicate N/A. 2. Use additional sheets if necessary. Reference Item number from the application. 3. References: Be sure to include your information as well as the person providing the reference. Other than your sponsor, family members cannot be a reference. Please make sure your references complete their part of the reference sheet. It is required that one of your references is your sponsor for club membership. Insure that your sponsor completes the reference portion of the application. Sponsor may be a family member. 4. Employment information must be completed. Be sure to include all information. In the area of dates worked, input your start and end date. 5. Include all information requested about sporting or shooting organizations for which you are currently a member. Be sure to include the numbers of years you have been associated with each organization. 6. Be sure to include your club sponsor information and obtain your sponsor s signature prior to submitting the application. If this information is not completed, the application will be disapproved. 7. Once your application is submitted, the membership committee will review it. If your application is complete and the membership committee feels you would be a good candidate for membership, the committee will schedule an interview with you and your sponsor. Upon completion of the interview, the membership committee will make a recommendation to the executive board, which will make a decision regarding your potential membership. If approved, the executive board will bring your application up for vote at a monthly club meeting for probationary membership. 8. Additionally once an application is received, we will notify you by letter that your application is under review. You will also be notified that your name has been placed on a waiting list if no openings are available for membership. Once an opening is available and your application is approved you will be scheduled for an interview. 9. Additional information may be requested at the interview so that a background check can be conducted in the event that the executive board deems it necessary. 10. Applications can be submitted to the Membership committee at a regular club meeting or mail application to Amy Pascale, Secretary, 87 Dagobert Street, Wilkes-Barre, PA 18702.

APPLICATION FOR MEMBERSHIP Date of application: 1. GENERAL INFORMATION: Name: Date of Birth: Address: NRA Membership # (REQUIRED) Phone # Cell Phone # Email Address: Can we text you ( ) YES ( ) NO 2. CITIZENSHIP: Are you a Citizen of the United States of America ( ) YES ( ) NO 3. EDUCATION: High School (Name) College (Name) Trade School (Name) Graduate: ( )YES ( )NO Graduate: ( )YES ( )NO Graduate: ( )YES ( )NO 4. REFERENCES: Attached are three reference forms to be filled out by you and three character references, excluding relatives: 5. EMPLOYMENT: Provide the following information on your present and past employers: Company Name and Address: Company Name and Address: Dates of Employment: From: To: Dates of Employment: From: To: 6. MILITARY SERVICE: Branch of Service: Date of Entry: Date of Discharge: Type of Discharge:

7. ORGANIZATIONS: Provide the following information on shooting or sportsman organizations that you are presently affiliated with: Name of Organization: Name of Organization: Membership # Membership # Years associated: Years associated: 8. ADDITIONAL INFORMATION: Have you ever been arrested for any reason, excluding minor traffic violations? ( )YES ( ) NO If Yes, indicate the nature of the offense, place, and final disposition: Are you an unlawful user of any controlled Substance? ( )YES ( ) NO Are you now or ever been PROHIBITED from owning, collecting, or being in possession of firearms or having had firearms confiscated from you by any law enforcement officer? ( )YES ( )NO If Yes, explain: 9. SPONSOR INFORMATION: Rifle Club Member Name: Address: Phone #: Years of service in club: 10. REQUIRED SIGNATURES: I,, certify that the information provided is accurate and true. Signature of Applicant

Applicant Reference 1. GENERAL INFORMATION: Applicant Name / Address Reference Name / Address Applicant Phone #: Reference Phone #: Best time to contact you: 2. Nature of association to Applicant and how long you have known the applicant. 3. Please inform us as to why the applicant should be considered for membership into the Wilkes-Barre Rifle and Pistol Club. Include information to his Character and Integrity.

Applicant Reference 1. GENERAL INFORMATION: Applicant Name / Address Reference Name / Address Applicant Phone #: Reference Phone #: Best time to contact you: 2. Nature of association to Applicant and how long you have known the applicant. 3. Please inform us as to why the applicant should be considered for membership into the Wilkes-Barre Rifle and Pistol Club. Include information to his Character and Integrity.

Applicant Reference 1. GENERAL INFORMATION: Applicant Name / Address Reference Name / Address Applicant Phone #: Reference Phone #: Best time to contact you: 2. Nature of association to Applicant and how long you have known the applicant. 3. Please inform us as to why the applicant should be considered for membership into the Wilkes-Barre Rifle and Pistol Club. Include information to his Character and Integrity.

Membership Committee Checklist Date Application received by committee: Date that application was reviewed: Membership Committee members that reviewed application: Person Name Applying for membership: Sponsor of applicant: Is the application filled out completely: Membership and Annual Fee ($150.00) Submitted: Date of Interview: Copy of bylaws provided to applicant: Notes from interview: Recommendation to the Executive Board: ( ) Approved ( ) Disapproved Notes from the Executive Board: Executive Board is bringing to vote that be granted probationary membership into the Wilkes-Barre Rifle and Pistol Club. Based on the vote of the members present on this day. is granted probationary membership for one year, after which a vote will be taken to bring the probationary member to status of MEMBER.

SPONSOR CHECKLIST Date in which probationary membership granted: Membership ($50.00) and Annual Fee ($100.00) received $150.00 total Probationary Member Name: Sponsor Name: Probationary Period: Has the probationary member received a copy of the bylaws: ( ) YES ( ) NO The following checklist is the sponsor s responsibility. The checklist must be turned into the Membership Committee once the probationary member has completed all the requirements or the year probationary period is up. In order for the probationary member to become a full member the checklist must be sent to the executive board with a recommendation from the Membership Committee. Once the executive board makes a decision to bring the probationary member to status of MEMBER, the recommendation will be voted upon at a regular club meeting. If the year probation period is over and the checklist has not been turned into the membership committee the probationary member will be expelled from the club. If the probationary member has not completed all the requirements for full membership within the year of probation, the sponsor may request an extension and explain in detail why the probationary member was not able to complete the requirements. The membership committee will either grant an extension to the probation period or make a recommendation to the executive board for membership. The sponsor is required to insure that the probationary member completes each requirement and indicate the date that the requirement was fulfilled by the probationary member. The probationary member must complete the following items: 1. Attend work day number 1 or 8 hours: 2. Attend work day number 2 or 8 hours: 3. Attend conventional pistol match:

4. Attend high power rifle match: 5. Attend I.D.P.A match: 6. Attend handgun silhouette match: 7. Attend small bore match: 8. Attend monthly club meeting: 9. Attend monthly club meeting: 10. Attend Fun shoot: 11. Help in the kitchen for a match of choice: 12. Submit required dues: Recommendation by Sponsor: Date in which checklist was turned into the Membership Committee: Members of Membership Committee that reviewed checklist: Recommendation of Membership Committee: ( ) Approve for MEMBERSHIP ( ) Disapprove for MEMBERSHIP Comments to Executive Board: Recommendation of Executive Board: ( ) Approve for MEMBERSHIP ( ) Disapprove for MEMBERSHIP Probationary Member has completed all requirements required by the Membership Committee and has been approved by the Membership Committee and the Executive Board for status of MEMBER to the Wilkes- Barre Rifle and Pistol Club. Therefore a motion to except to status of MEMBER is brought to the members present at this regular club meeting on (Date) All in favor: (# in favor) All not in favor: (# not in favor) The motion to bring as full member is granted on this day.