Washington Arms Collectors

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	Check here if you are only updating your address/data

WAC Member Number:

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Last Name:
First Name:
Address:
City:
State: Zip Code:

Home Phone:
Work Phone:
Fax Number:
E-mail Address:

Phone Tree?:

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Driver's License:
Driver's License expiration date:
Birth date:
U.S. Citizen? Yes No (Provide Alien License #)
Alien Firearms License #
C.P.L. #:
C.P.L. Expiration:
F.F.L.#:
Occupation:
Employer:
Years Employed:

Which type of membership are you applying for:

Full Membership ($35/yr):
Life Member ($500):
Associate Member ($20/yr):
Spousal and Family ($10.00/yr):

Amount enclosed:

I agree to be bound by the Bylaws, rules and policies of the of the Washington Arms Collectors, Inc. I also agree to retain personal liability insurance and to obey all applicable local, State, and Federal laws, ordinances, and regulations pertaining to firearms, ammunitions and accessories, and accept full responsibility for maintaining a current awareness of the legal restrictions, proscriptions, and penalties applicable to firearms, ammunition, and accessories. Additional, I attest that I am not a member of any group that advocates that overthrow of the United States Government or seeks to subvert the Rights ad Principles set forth in the United States Constitution or the Declaration of Independence.

I hereby swear that I am NOT1) A CONVICTED FELON; (2) A DRUG ADDICT; (3) AN HABITUAL DRUNKARD; (4) UNDER INDICTMENT FOR A FELONY OR GROSS MISDEMEANOR INVOLVING DEADLY FORCE; (5) A PERSON WHO HAS BEEN ADJUDGED MENTALLY INCOMPETENT.

I authorize the Washington Arms Collectors to verify the accuracy of the statements and information I have provided on this confidential application for membership I also waive any liability that might otherwise attach to those organizations and individuals who aid in the corroboration or refutation of the data on this application or the statements attested to by me. I authorize the release of all information whatsoever to the Washington Arms Collectors, and its presiding officers that will aid in the judging the merits of this application. My signature on this form also acknowledges acceptance of the Puyallup Fairground’s hold harmless agreement, available at membership services.