MEMBERSHIP APPLICATION
I hereby apply to join Hillcrest Indoor Pistol Club Pty Ltd
ABN 71 600 072 357
Approved Club No 80001538 (Weapons Act 1990)
Address: 18 Elliott Court Hillcrest, QLD, 4118
Ph: (07) 3800 0380
HILLCREST INDOOR PISTOL CLUB PTY LTD
Title
Miss
Mr
Mrs
First Name (Legal name i.e. Robert Not Bob)
Ms
Dr
Middle Name (Legal name i.e. Robert Not Bob)
Fthr
Sir
Surname (Sometimes called family name)
Name
HOME Street Address (Number and Name)
Suburb
Postcode
Address
Date of Birth (Use dd/mm/yyyy format please)
Email address
Home Phone Number
Work Phone Number
Mobile Phone Number
Phone(s)
Driver’s License No
Expiry Date
Concealable License No
Expiry Date
Other Weapons License No
Expiry Date
Identification
Declaration re Club Membership
I declare that I am NOT a current member of any other shooting club (Section 98B I Weapons Act 1990) Or
I declare in accordance with Section 98B I of the Weapons Act 1990, that I am a financial member of: (Insert Details Below)
Club Name
Membership Number
Membership Expiry Date
Category(s) of Membership ( A-B-C-D-H-M-R as applicable)
Club Name
Membership Number
Membership Expiry Date
Category(s) of Membership ( A-B-C-D-H-M-R as applicable)
Police Approvals (Unlicensed Applicants)
In accordance with Section 98B (1) of the Weapons Act 1990 It is a condition of an approved pistol club’s shooting club permit that the club
must not accept a person for membership of the club unless the person submits with the person’s application for membership (if the person
is not a licensee), a current statement of eligibility in the approved form signed by an authorised officer that the person is a fit and proper
person to hold a licence; (Form QP0515) is available from Queensland Police Weapons Licensing Branch Website)
Instructions
Complete the Form QP0515 and lodge at your nearest police station, once you receive your statement of eligibility signed by the authorised
officer, attach the statement of eligibility to this application form and bring to the club (within 90 days) for issue of your membership. (A
statement of eligibility that is dated more than 90 days ago is not valid)
Character Reference # 1 (All Applicants)
In accordance with Section 98B (1) of the Weapons Act 1990 It is a condition of an approved pistol club’s shooting club permit that the club
must not accept a person for membership of the club unless the person submits with the person’s application for membership 2 character
references from persons the person has known for at least 2 years. (You can use this form or attach written references)
Insert Proposed Members Name
To Hillcrest Indoor Pistol Club Pty Ltd,
I have known the applicant
Insert Number of years.
For
Years
During the period of time I have known the applicant they have always demonstrated the personality traits in my opinion that make them a
suitable person to join a pistol club, I sign this reference with the knowledge that being a member of an approved shooting club will entitle
the applicant to obtain a concealable firearms license and purchase ammunition and firearms.
Referee’s Name
Referee’s Signature
Referees Address (Street Number, Name, Suburb & Postcode)
Date of Signing
© 2015 Hillcrest Indoor Pistol Club Pty Ltd
Referee’s Email Address
Referee’s Contact No
Character Reference # 2 (All Applicants)
In accordance with Section 98B (1) of the Weapons Act 1990 It is a condition of an approved pistol club’s shooting club permit that the club
must not accept a person for membership of the club unless the person submits with the person’s application for membership 2 character
references from persons the person has known for at least 2 years. (You can use this form or attach written references)
Insert Proposed Members Name
To Hillcrest Indoor Pistol Club Pty Ltd,
I have known the applicant
Insert Number of years.
For
Years
During the period of time I have known the applicant they have always demonstrated the personality traits in my opinion that make them a
suitable person to join a pistol club, I sign this reference with the knowledge that being a member of an approved shooting club will entitle
the applicant to obtain a concealable firearms license and purchase ammunition and firearms.
Referee’s Name
Referees Address (Street Number, Name, Suburb & Postcode)
Referee’s Signature
Date of Signing
Referee’s Email Address
Referee’s Contact No
Membership Category (s)
Hillcrest Indoor Pistol Club Pty Ltd is approved by the Queensland Police to be an approved club (Our approval no is 80001538) for the
purposes of the Weapons Act 1990. The club is approved for possession and use of category A Weapons, Category B Weapons and
Category H Weapons for sports target shooting.
1
Full Membership
2
Family (2 x Adults + 2 x Juniors [11-17 yrs old] (An additional $120 per child there after)
$550.00 p.a
3
Junior
$250.00 p.a
4
Pensioner
$300.00 p.a
5
A & B (Red Card Membership)
$75.00 p.a
(member to use the range every day at no charge, except when organised competitions are being conducted)
(a $25 range use fee applies on each visit each day).
$380.00 p.a
Membership Fees
The Clubs financial year is 1st July to 30th June each year, and membership fees will be applied on a pro rata basis as follows:
Full Members who join/renew on 1st July each year the membership fees are $380, during the period 1st July to 30th Sept membership fees
are $320, during the period 1st October to 30th December are $260, and 30th December to 30th March are $200. Membership between 1st
April and 30th June each year is $430 (12 Months plus balance of old financial year). A & B Membership is $75 Per Year (or part thereof) or
$50 for Pro Rata from 1st January to 30th June each year)
Membership Application
I the person named in section 1 of this application form, hereby apply to join Hillcrest Indoor Pistol Club Pty Ltd and agree to the following:
I agree to abide by the clubs quality management procedures and range rules on each visit to the club.
I agree to obey the instructions of range officers at all times.
I will not attend the club whilst under the influence of drugs and or alcohol.
I will not use my firearm at the club in any way to deliberately harm any range equipment or person.
I attach copies of my Weapons Act Licenses OR the original “Statement of Eligibility”
I Include my membership fee of $
(Or a completed Direct Debit Request (DDR) to pay my membership fees monthly)
I agree to my credit card being deducted the membership fees from my Visa or Mastercard as listed below:
Card Number (Visa or Mastercard only)
Membership Fee
Expiry Date (dd / mm)
CCV (3 digits)
$
Proposed Members Signature
Dated this (insert date)
Card Holders Signature (If card holder is NOT the member, the card holder acknowledges that they are authorising
the payment of the proposed members membership fees in VIP Shooting Club Pty Ltd
Signed:
© 2015 Hillcrest Indoor Pistol Club Pty Ltd
Dated:
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