Affiliation Application Form Page 3
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4CMP Affiliation Application Form
Page 3 Updated 09/23/2014
Membership Contact: Please provide the name
and contact information for the adult leader who
Name__________________________________________
should receive all inquires of affiliation will your club.
This person may be the club secretary, junior
Title____________________________________________
director or chairman, program director or other
responsible adult. If the person listed as the primary
Date of Birth______________________________________
leader above is also the Membership Contact
Person, write ‘same’ in the name line.
Address_________________________________________
City/State/Zip_____________________________________
Email___________________________________________
Junior Marksmanship Programs. Please
check all of the marksmanship programs
____ BB gun
____ Air rifle
____ Air Pistol
that are offered to junior members or
participants (for colleges, persons aged 27
____ 50 foot smallbore rifle
____ Smallbore pistol
and below).
____ Highpower rifle
____ Metallic silhouette
____ Clay target
____ Other, please describe:________________________
____ Our organization does not offer a junior
marksmanship program at this time.
Range Facilities. Please describe the
range or ranges that your organization uses
____ 5 meter BB gun, number of positions _______
to conduct its marksmanship activities. Check each
of the ranges used by your organization and provide
____ 10 meter air gun, number of firing points _______
the additional information requested.
____ 50 foot smallbore, number of firing points _______
____ Outdoor smallbore, maximum distance (circle one)
50 feet
50 yards/meters
100 yards/meters
____ Outdoor highpower rifle
Maximum distance (# of yards) __________
Range is (check one):
____ Owned or controlled by our organization
____ Leased from or provided by another organization,
Describe:________________________________
____ Our organization does not have a range now, but
plans to develop a range in the future.
Release of Club Information: Can the CMP
Please check one:
release your club’s information and membership
contact’s information on our website? This will allow
_____ Yes
_____ No
your members and new members to view your
information.
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