PHILIPPINE PRACTICAL SHOOTING ASSOCIATION

4/F Unit B Strata 2000 Emerald Ave. Ortigas Center Pasig City
Telephone No. 8-332-8210
Email: membership.ppsa1984@gmail.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 D
Master
NROI Ranking : Range Chief Range Range
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. Active Range Officers in Luzon who
A. Fill up Individual Membership Application Regular Member P 2,000.00 P1,000.00 have served a minimum of 36 points
Form Regular Junior 1,000.00 500.00 and 18 points in Visayas and Mindanao
B. Attach 2x2 colored picture – 1 pc Lawman (PNP, AFP) 500.00 500.00 RO are exempted from these fees as
C. Gun club President Signature Lifetime 10,000.00 NONE long they are endorsed by the NROI
Switch to Life N/A 9,000.00
D. Membership Fee Secretariat
NALECC 1,000 500.00
B. All Range Officers must be endorsed
-Lawman and NALECC must be present their by their Gun Club President
current active ID to avail the discounts. C. Policies may be changed by the PPSA
-Rates are subject to change without prior Board of Directors.
notice: