U.S. NAVY MARKSMANSHIP TEAM - WEST (2016)

PACFLT #: CMP # APPLICATION FOR FLEET AND ALL NAVY WEST MATCHES

Personal Information (All Competitors)

Full Name:
Last / First / M.I. Rank/Rate
Home Address:
Street Address / Apartment/Unit #
. / .
City / State / ZIP Code
Social Security Number / XXX-XX- STATE / DRIVERS LICENSE # Date of Birth
BEST CONTACT PHONE NUMBER WHILE AT THE MATCHES (ie, CELL, HOTEL, ETC):
E-mail Address: / . / SEX: MALE FEMALE
EMERGENCY CONTACT: / RELATION:
PHONE: / ( ) / ALT PHONE: / ( )

MILITARY STATUS: USN ACTIVE USN RETIRED USN RETAINER USNR ACTIVE USNR RESERVE (SELRES, ETC)

USCG USMC USAF USA COLLEGIATE CIVILIAN/RETIRED MILITARY (NON-NAVY) OTHER

Shooting Quals General (All Competitors)

  1. Are you a Distinguished Rifle Shot: Yes No Are you a Distinguished Pistol Shot Yes No

Year Distinguished: Number of points: Year Distinguished: Number of Points:

  1. DO YOU CONSIDER YOURSELF A COMPETITION EXPERIENCED SHOOTER (SPECIFY RIFLE, PISTOL OR BOTH)?

(ie, have you shot NRA competitions before or shot Fleet and Navy matches previously)? YES - RIFLE / PISTOL / BOTH or NO

  1. ARE YOU A NEW SHOOTER (YES/NO)? (ie NEVER COMPETED AT FLEET/NAVY/INTERSERVICE/NATIONALS LEVEL)

NAVY ONLY
NAVY-SERVICE QUAL / EX / SS / MK / WATCH / ALL COMPETITORS
NRA CLASSIFICATION / HM / MA / EX / SS / MK / UNCLAS/UNK
SERVICE RIFLE / NRA RIFLE
SERVICE PISTOL / NRA PISTOL

*Retired Navy only: Number of EIC points earned while in uniform: If over 10 Navy points, do you wish to counted in the Navy count or CMP Civilian count during these competitions? Navy CMP Civilian

MATCH PARTICIPATION (All Competitors)

FFC (PAC) (BOTH), RIFLE INDIVIDUAL OR PISTOL INDIVIDUAL(Includes EIC's) - $50. (Single Fee)

EVENTS / SPECIFY / EVENT AMOUNT / FEES: (Enter Amount)
*FFC (PAC) (ALL EVENTS, Including EIC's) / RIFLE PISTOL BOTH / $50 (ANY or ALL)
*ALL NAVY (ALL EVENTS, Including EIC's) / RIFLE PISTOL BOTH / $50 (ANY or ALL)
TOTAL:

Entries Can Be Sent Emailed To Along With Payment Via PAYPAL.

If Mailing then send this form and match fee's To: USNST-PAC, PO BOX 3112, La Mesa, CA 91944-3112

NOTE: When you check in with the statistical office you will be given your competitor number, your domestic violence disclaimer will be filled out and signed (all competitors), and your informed consent and waiver of liability will be filled out and signed (civilians/retired only).

Command Information (Active/Reserve Navy Only)

CMD NAME:

Misc Information

1. Will you be staying at Lake O'Neill Yes No