Application for Membership in the Ashe County Wildlife Club, Inc

 

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Full Legal Name______________________________________________

Date of Birth: ________________________ Sponsor ( Must be Current Member ) __________________

Mailing Address_______________________________________________________________

City____________________________State_________Zip Code_________________________

Occupation_______________________________________________________________

Home Telephone________________________Work Telephone_____________________

NRA Membership # (Recommended)__________________Expiration________________

Email Address_____________________________________________________________

Please answer the below questions, “Y” for “Yes”, “N” for “No:”

• Have you ever been denied the purchase of a firearm? ______
• Have you been convicted of any wildlife violations in the past five (5) years? ______
• Are you currently charged with a felony or have you been convicted of a felony in the past Five (5) years? _______
• Are you an unlawful user or are you addicted to or a habitual user of any controlled substance, drug, or alcohol? _____
• Have you ever been judged mentally ill or been committed to any kind of mental institute? _____
• Are you currently under any court orders relating to any criminal act? _______
• Have you ever been convicted of domestic violence of any kind? _______
• Are you the person applying for membership? ______
• Are you currently a U.S. Citizen? ________
• Do you agree to abide by Club Rules, guidelines, and by-laws? ______
• If physically able, will you participate in Club Activities, including work days and fix-up and improvement projects? _____
• I understand and agree I have answered all of the above questions honestly. I also understand ANY CHANGES to the above answers may result in termination of my membership from the club, and require surrender of any and all keys to access the Club property. _______

TO BE CONSIDERED FOR MEMBERSHIP, you must have answered “No” to questions 1 thru 7, and answered “Yes” to questions 8 thru 12. If you have answered otherwise and still wish to be considered for membership, please explain below:

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I hereby certify by this application that I have truthfully answered the above questions and fully understand I can be turned down for membership, or have my membership terminated for falsifying this information or committing any wildlife violations or any other act deemed detrimental to the ACWC, Inc., while a member.

Furthermore, my signature below acknowledges and grants permission for the Ashe

County Wildlife Club, Inc, to have a criminal background check run to verify the above answers I have given are, in fact, correct and I am fully eligible to become a member of the Ashe County Wildlife Club.

IF my application is accepted, I also pledge to support the goals & objectives of the Ashe

County Wildlife Club, Inc. These are to promote and support:

-Good Sportsmanship,

-Conservation of Wildlife,

-The Safe use of Firearms,

-The Right to Hunt and Fish, and the Constitutional Right to Bear Arms, as Guaranteed by

the Second Amendment to the Constitution of the United States of America,

-Cooperate with all state and Federal Agencies in the Protection and Restoration of our

Natural Resources,

-the Pledge of Allegiance and open, Public Prayer as they relate to our Club Meetings

and Events.

Signature of Applicant______________________________________ Date_________________

Applicant, please circle desired membership below:

***Standard Membership Dues are all-inclusive for all shooting activities offered on the Club Property and also include a Shooter’s Discount on all Shotgun Shooting Activities.

Areas of Interest (Check all those that apply):

Wildlife Conservation_____ Big-Game ____ Small-Game ____ Sporting Clays____

Target Shooting____ Fishing___ Cowboy Action___ IDPA____ Other___________Comments:

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