Application for Membership:Sagamore Rifle Club, Inc.

P.O. Box 638 Sagamore, Massachusetts 02561

organized 1931 Incorporated May 11, 1953

Applicant must obtain the signatures of two members “in good standing” recommending him/her for membership. All lines must be filled in before submitting this application. Membership is not guaranteed. Applicant must be present when the ‘membership vote’ is taken. Payment will be submitted by check or money order at the time of induction into the club.

Applicant______Address______

P.O. Box______City______State______Zip Code______

D.O.B. ______Occupation ______U.S. Citizen? Yes/No______

Telephone Number______Email Address: ______

#1 Sponsoring Member Name______Signature______

#2 Sponsoring Member Name______Signature______

  1. Are you presently a member, or a past member of a rifle/pistol club? Yes/No______

Name of club(s)______

______

2. Are you currently a *member of:

a. NRA ID#______Exp:______b. GOAL ID# ______Exp:______

*All club members must belong to both NRA and GOAL. If at this time, you are not a member of NRA or GOAL, your submitted application for membership; to include appropriate filing fees in the Sagamore Rifle Club, Inc. will not be acted upon until proof of membership in NRA and GOAL have been established.

3. Have you ever been found guilty in a criminal court action? Yes/No______If, Yes, please explain. ______

4. Do you have an F.I.D. card? Yes/No______If, yes, FID#______

5. Do you have a License to Carry Firearms? Yes/No_____ If, yes, Class Type: ______

License Number ______Expiration Date______

6. Please, list reasons for wanting to join the Sagamore Rifle Club, Inc.______

______

______

7. Please, list three names, with address and telephone numbers for character references.

Name Address Phone Number

1. ______

2. ______

3. ______

I hereby apply for application in the Sagamore Rifle Club, Inc., and agree, if elected to membership, to abide by the laws, rules and regulations of the S.R.C., Inc., while a member thereof.

I swear to the following oath of allegiance:

“I pledge allegiance to the flag of the United States of America, and to the republic for which it stands.”

I certify that I am a citizen of the United States of America, and that I am not a member of any organization or group, pledged to, or working for, a program aimed at the destruction of our present form of government established by the Constitution of the United States of America.

I have truthfully answered the above questions to the best of my knowledge and beliefs under the penalty of perjury. Furthermore I authorize the Executive Committee of the Sagamore Rifle Club, Inc., to verify all information provided in this application.

Signature of Applicant______Date______

Note: If The Sagamore Rifle Club, Inc. is at maximum membership at the time of application tenure. Applications will be held in the order received and voted on when memberships become available. No payment is not due until you are voted in as a member.

______Club use do not fill-in below this line______

Application Fee of $100 and 1st Year Dues of $50 for a total of $150.

Received by ______

Elected on______

Meetings are held every second Wednesday of the month.

For more information visit us at sagamorerifleclub.com

Date of Application received by the SRC Secretary ______

Revised February 2015