Felixstowe Rifle Club
Walton Hall Range, Felixstowe
Application for Club Membership
Full Name:Date of Birth
How long have you lived at this address? years
If less than 1 year, your previous address:
Place of Birth:
Name of current employer
Tel Number Service with current employer years
If less than 1 year, your previous employment details
Declaration by Applicants under section 21 of the Firearms Act 1968
- A person who has been sentenced to preventative detention or to imprisonment or to corrective training for a term of three years of more, or who has been sentenced to be detained in a young offenders’ institution in Scotland, shall not, at any time, have a firearm or ammunition in his possession.
- A person who has been sentenced to borstal training, to corrective training for less than three years, or to imprisonment for a term of three months or more, but less than three years, or who has been sentenced to be detained for such a term in a detention centre or in a young offenders’ institution in Scotland, shall not at any time before the expiration of a period of five years, from the date of his release, have a firearm or ammunition in his possession.
I herby declare that I am not prohibited from possessing a firearm or ammunition by virtue of the above section. If my application is accepted, I agree to abide by the rules and regulations of the club at all times.
Do you hold a firearm or shotgun certificate?
If YES, Certificate no. Issued By:
Have you ever been refused or had a firearm or shotgun certificate revoked?
If YES, give reason:
Details of proposed shooting, please mark with ‘X’
.22 RimfirePistol Calibre CarbineBlack PowderAir Rifle/Pistol
Do you know any members of Felixstowe Rifle Club?
If YES, please state who:
Give full names and addresses of 2 referees who may be contacted by the club:
(These referees must have known you for a minimum of 2 years and must not be immediate family).
Do you know of any reason why you may be refused a firearm certificate?
If YES, give reason:
Enclose 2 passport size photographs. Print name on back of each photo
Applicant’s signature: Date:
If under 18, parent/guardian Name:
Official Use Only
Date of Application:
Date of Committee Review
Membership TypeOrdinaryJunior Senior Blind/Disabled
Approved /RefusedSent / Received / Reminder / Comments
Police Letter (New applicant)
Passed to Committee
Offer of Membership
Joining Fee Paid
NSRA Membership No.
Police Letter (Full member)
FRC Membership Card
Leaver Notification to Police