Licensed shooters online application







	Pay your membership joining fee and buy merchandise online with this form Complete and submit the form below; it will take you to a secure credit card transaction form at eWay. After you make your payment please press the Send confirmation email button.)


Important - Please supply an email address for a transaction receipt (Required fields are marked with an asterisk*)
Title
First Name*
Middle Name
Last Name*
Email address*
Postal Address*
State*
Postcode*
Residential Address
Day Phone
Home Phone*
Mobile
Fax
Date of Birth (dd/mm/yy)*
I am currently licenced and a member of:	Club for my genuine reason.
My firearms licence number is:
I wish to use ATSC membership as genuine reason to gain my firearms licence*
I wish to acquire a licence for:* (you may select more than one category. Type '1' in the category/categories you choose.) *Applications for membership for a Probationary Pistol Licence must be accompanied by two (2) character references from persons of 18 years or above who have known you for at least two (2) years.	Target Shooting Category A Target Shooting Category B Probationary Pistol Licence (PPL)* Recreational Hunting Category A Recreational Hunting Category B Collecting Category G
Cost for New Shooter Membership	@$54.00 each
Additional cost for insurance loading. (Recreational Hunting Licence - both categories)	@$16.00 each
Additional cost for pistol training (Probationary Pistol Licence (PPL))	@$187.00 each

ATSC Caps	@$15 each
Ladies Polo Shirts, white embroidered with logo	@$35 each sizes
Mens Polo Shirts. white embroidered with logo	@$35 each sizes
Additional Shoulder Patch	@$5.50 each
Additional Tie Pin	@$7.50 each
Additional Badge	@$3.00 each


Amount Payable (please enter the amount for the total in cents. i.e. $70.00 =7000)