Register your interest in joining MISC – Melbourne International Shooting Club

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Please complete the form below to register your interest in joining our Club.

Name *

First

Last

Date of Birth *

Sex

Male
Female
Other

Other option

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Mobile Phone

Email *

Prohibited Person Declaration *

Are you a Prohibited Person as defined under the Victorian Firearms Act 1966?

Health Declaration *

Are you currently, or have you in the last 5 years suffered or been treated for any of the following: psychiatric or psychological conditions (e.g. depression, stress or emotional problems); alcohol or drug dependence; neurological conditions (e.g. stroke or head injuries); serious impairment of eyesight; fits, dizziness or blackouts; or have any medical condition that could impact on your ability to use a handgun in a manner that is safe to yourself and others?

Why are you interested in shooting? *

Do you have a current Firearm Licence? *

Handgun Licence
Rifle Licence
No Licence

Are you a member of another Shooting Club *

If a member of another Club please state which Club

What Competitions are you looking to participate in? *

ISSF
WA1500 Matches
Service Matches
Combined Services
Western Action
Air Pistol
IPSC (Note that this Club in not set up for IPSC competitions or events.)
Don't know
Other

Best Contact Method *

Phone/Mobile
Text
Email

How do you know about us? *

Our Website
Friend
Recommendation
Other

Any further information you would like to submit.

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