APPLICATION FOR WGC MEMBERSHIP
NAME: ________________________________________________________________________
STREET ADDRESS: ______________________________________________________________
CITY, STATE, ZIP: _______________________________________________________________
PHONE DAY: _____________________ EVENING/CELL: _____________________________
EMAIL: _________________________________________
DATE OF BIRTH: _____________
CITY/STATE OR COUNTRY OF BIRTH________________________________________
ARE YOU A CITIZEN OF THE USA? YES / NO
OTHER COUNTRY ____________________________________________________
IF NOT A USA CITIZEN, ALIEN REGISTRATION #: _______________________________
DO YOU HAVE A MASS. FIREARMS LICENSE? YES / NO
TYPE OF LICENSE: __________________________________________
LICENSE #:_________________________________________________
EXPIRATION DATE: _________________________________________
ARE YOU A MEMBER OF THE GUN OWNERS ACTION LEAGUE (GOAL)? _______
CHARACTER REFERENCES- 3 REQUIRED (NO RELATIVES PLEASE)
NAME ADDRESS CITY ZIP PHONE
1. ________________________________________________________________________________________
2. ________________________________________________________________________________________
3. ________________________________________________________________________________________
I CERTIFY THE ABOVE INFORMATION IS TRUE TO THE BEST OF MY KNOWLEDGE. IF ACCEPTED INTO MEMBERSHIP, I AGREE TO ABIDE BY THE RULES, REGULATIONS, RESPONSIBILITIES, AND BY-LAWS OF THE WESTWOOD GUN CLUB INC. I WAIVE ALL CLAIMS AGAINST THE WESTWOOD GUN CLUB INC. AND AGREE TO HOLD BLAMELESS THE OFFICERS, DIRECTORS, AND MEMBERS FOR ANY ACT IN CONNECTION WITH THE ACTIVITIES OF THE CLUB.
SIGNATURE OF APPLICANT: ___________________________________ DATE: ______________
WGC USE ONLY - DATE ADMITTED OR REJECTED: __________________________________
4/11/10
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