PHILIPPINE PRACTICAL SHOOTING ASSOCIATION

3rd Floor Macrima Bldg. cor. EDSA Escuela St. Nuevo Makati City
Telephone No. 8828244 Fax 8827973
Email: a.ppsa@yahoo.com.ph / rjbautista.ppsa@yahoo.com

INDIVIDUAL MEMBERS APPLICATION FORM

Date Applied:

New Member Renewal

PPSA ID No. Family Name First Name Middle Name

Nick Name : IPSC Alias

Birthday : Birth Place
Civil Status : Single Married Gender
Occupation : Blood Type: A B O

Membership Type : Regular Honorary Life Membership Date:

RCS Classification : Grand Master A B C DD
Master
NROI Ranking : Range Chief Range Range
RO POINTS
Officer Officer Master

Mother Club Name : Position:

Contact Information Home

Address : Zip Code :

Mobile No. :

Email Address: Telephone No. :

Contact Information Office

Address : Zip Code :

Mobile No. :

Email Address: Telephone No. :

The information is, to the best of my knowledge, accurate and complete. I agree to conform to the Code
of Conduct, rules and policies of the PPSA and comply with the obligations of membership.

Endorsement:

2x2 ID Picture
Gun Club President
(Signature over Printed Name)

(Applicant signature should be inside the box)

REQUIREMENTS: MEMBERSHIP FEES: RANGE OFFICERS:

New Member Renewal
A. Fill up Individual Membership Application Regular Member P 2,000.00 P1,000.00 A. Active Range Officers who have served
Form Regular Junior 1,000.00 500.00 a minimum of 18 points are exempted
B. Attach 2x2 colored picture 1 pc Lawman (PNP, AFP) 500.00 500.00 from these fees as long as they are
C. Gun club President Signature Lifetime 10,000.00 NONE endorsed by the NROI Secretariat
Switch to Life N/A 9,000.00
D. Membership Fee B. All Range Officers must be endorsed
NALECC 1,000 500.00
by their Gun Club President
-Lawman and NALECC must present their C. Policies may be changed by the PPSA
current active ID to avail the discounts. Board of Directors.
-Rates are subject to change without prior
notice: