Application for Membership

 

THE NIAGARA COUNTY SPORTSMENS ASSOCIATION INC

2506 Lower Mountain Road (Bond Lake Park), Ransomville, N.Y. 14131 Ph. 716-731-4535

This application is a Draft / Work Copy Only. Official applications must be completed upon interview.

 

Date _____________.              Member Number_________

                                                                                                   (Leave Blank)

 

Print Name___________________________________________________________

(First)                                       (Middle)                                           (Last)

 

Address__________________________________ Phone (______)_______________

 

City__________________________________ Zip Code____________-___________

 

Occupation ________________________ Age ____ Date of Birth_____/_____/_____

 

E-mail Address (optional) ________________________________________________

 

Check activities of Interest

‰ Fishing.                                     ‰ Rifle.                                     ‰ Work on Grounds and Buildings.

   ‰Archery.                                     ‰ Shotgun.                               ‰ N.R.A. Member (Yes/No)_______

 ‰ Black Powder.                          ‰ Pistol.                                    ‰ U.S. Citizen (Yes/No)_________

 

I, _________________________ certify that I am not a member of any organization which has

any part of its program the intent to overthrow the government of the United States by force or violence.

And that if admitted to membership, I will fully subscribe to the Constitution and by-laws of the

Niagara County Sportsman Association Inc.

 

ANY APPLICANTS THAT DO NOT POSSESS A NEW YORK STATE PISTOL PERMIT MUST INCLUDE A

BACKGROUND CHECK SUPPLIED BY THE SHERIFF’S OR THE RMCP RECORDS DEPARTMENT

 

I PLEDGE 10 HOURS OF WORK ANNUALLY FOR THE FIRST TWO YEARS OF MEMBERSHIP

 

Interviewed by: ___________________________        _____________________________

                                                                                                                                    (Signature of Applicant)

 

=================================================================

 

Club References _____________________.   ________________________.   ____________________.

 

New York State Pistol Permit Number______________________

 

Background Check:  Agency_____________________________ Date __________________

 

Dues Rec’d: $ ____________ Date ________________ By ___________________________

 

COMMENTS _______________________________________________________________

 

Interviews are held on the second Sunday of each month at 12 PM sharp, prior to our 2 PM Membership Meeting.

And at 7 PM sharp, on the second Tuesday following the Membership Meeting

 

The Board of Directors must approve all applicants before any action is taken on their Application.

No use of the ranges will be permitted until membership card is issued.