(Incorporating the Welsh XX Club and Welsh Gallery Rifle Club)

APPLICATION/RENEWAL FOR MEMBERSHIP

Please ensure all boxes are completed or put N/A if not applicable

Surname: / Forenames:
Address:
Postcode:
Date of Birth: / Any Previous Surname:
Tel. Home: / Tel. Work:
Mobile No: / E:mail:

NOTE 1: Please complete date of birth as the NRA require this on our annual capitation return for the insurance cover. Please also complete the e-mail address clearly.

NOTE 2 : The fees below are the discounted fees forpaymentBEFORE 15 April,after which there is an additional £10 applied

Membership Classes: (Please tick whichever applies).

Full Shooting Member TR and/or MR £40[ ]

Junior Shooting Member (Under 25 on 1st Sep 2014)£25[ ]

Junior Shooting Member (in Full-time Education)£10[ ]

Gallery Rifle member only£12[ ]

Non NRA Member- Insurance Payment (Active shooter) £9 [ ]

(The WRA will issue your Certified Shooter card. NRA members receive it from NRA.)

Associate Member – Non-Shooting£12[ ]

Donation to WRA Funds ?????? [ ]

Club Affiliation only£15[ ]

Name of Club: ...... …Number of Members ...... ….

Cheques made payable to: “The Welsh Rifle Association” Total Enclosed £ .

ALL APPLICANTS

Current NRA Membership Number
Are you a qualified RCO? / Yes / No
Have you done an NRA Coaching Course? / Yes / No / Year?
I am happy to have newsletters and updates by E-mail / Yes / No
I enclose my membership card for renewal. / Yes / No
OR: Please issue me with a membership card. / Yes / No
I have enclosed my cheque made payable to the WRA(If paying by Standing Order please enter SO in the ‘No’ box.Ensure your standing order is for the correct amount for this year, the ‘Total enclosed’ above.) / Yes / No

INITIAL APPLICANTS ONLY

I wish to apply for membership of the WRA as indicated above.

Please provide details of refereeor sponsor. You will also be sent an additional Probationary member form
Name: / Tel. Home:
Address: / Tel. Work:
Mobile No:
Postcode: / E:mail:

All Applicants To Complete

Will the WRA be your PRIMARY named Club? YES NO

All membersholding a firearm certificate should understand that they must record their attendance at WRA organised shoots in the record provided in the Welsh XX Clubhouse (12 months non-attendance is advised to the Police[1]) and they mustconfirm the following details:

Do you own a Firearm Certificate?YESNO

If yes,and any details have changed, please forward a copy of your FAC (1st page and firearms list). Otherwise please sign the relevant box below.[2]

Signed
FAC Copy attached
FAC Details are not changed

Gift Aid declaration

There’s a quick and simple way in which you can make your membership subscription and donations worth 20% more to the WRA, at no extra cost to you.

Gift Aid Declaration. Charity name:- The Welsh Twenty Club. Charity number 258370.

I ...... (title) ...... (forenames)...... (surname)

wish that the Charity named above treat all membership fees and donations I have made since 6th April 2010 as Gift Aid Donations.

Signed: Date:

Notes1. You must pay an amount of income tax and/or capital gains tax at least equalto the tax that the charity reclaims on your donations in the tax year (currently 20p for each £1 you give).

2. If you are unsure whether your donations qualify for Gift Aid tax relief, ask the Charity or ask your local tax office for leaflet IR113 Gift Aid.

Declaration to be signed BY ALL MEMBERS :

I am not prohibited from possessing or handling a firearm or ammunition by virtue of section 21 of the Firearms Act 1968 (which applies to persons who have served a term of imprisonment) and I have never had a firearms or shotgun certificate revoked by the Police.

I am not aware of any reason why I should be refused membership of the WRA.

Signed: Date:

Gallery Rifle Only – Please submit to Dave Meaby – Secretary WRA GRC

at: 3 Nant Eos, Holywell, Flintshire CH8 7DA

All other members - Please return AS SOON AS POSSIBLE PLEASE to:

Secretary, WRA at: 18 Berens Rd., Shrivenham, Swindon, Wiltshire, SN6 8EG

[1] It is a legal requirement for us to inform the police of any new application for membership and non-renewal of membership or non-attendance in any 12 month period by all FAC holders.

[2] The information will not be distributed but it is a legal requirement that we have the information should the police require to check on members.