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PISTOL NEW ZEALAND (INC)

PISTOL CLUB MEMBERSHIP APPLICATION FORM (FM1)

Membership Number

0

NAME OF CLUB:

DATE:

APPLICANTS FIRST NAMES:

SURNAME:

ADDRESS:

POST CODE:

TELEPHONE: HOME:

BUSINESS:

CELL:

EMAIL:

FIREARMS LICENCE NO:

EXPIRY DATE:

DATE OF BIRTH:

Note: Probationary period cannot be completed until Applicant has advised PNZ of FLIC Number. We suggest that a “Utility Bill” be used to obtain a correct address and post code

I agree to the following conditions:
(1) A minimum six months probation period
(2) To abide by the rules of the Club
(3) To abide by the rules of Pistol New Zealand (Inc)

THE APPLICANT HAS ACCEPTED THE CONDITIONS

THIS FORM, ACCOMPANIED BY THE PNZ FEE, MUST BE SUBMITTED TO THE PNZ
WITHIN 28 DAYS OF COMPLETION

DATE FORM RECEIVED JOINING DATE RECEIPT NUMBER ENTRY LINE NUMBER DATE PACK SENT
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