Dedicated Sport Shooter Status

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Surname/Van:
Christian Names/Voorname:
I.D. No./Nr:
Member Association/Lid Vereniging:
Member No./Lid Nr:
CHASA Hunters Course Certificate No/CHASA Jagkursus Sertifikaat Nr:
Residential Address/Woonadres:
Work Address/Werksadres:
Occupation/Beroep:
Contract No./Kontak Nr: Work/Werk:
Home/Huis:
Cell/Sel:
E-Mail / E-Pos: General Information / Algemene Inligting List the calibers of all the firearms registered on your name./Lys die kaliber van al die gelisensieerde vuurwapens wat tans op U naam geregistreer is:
Do you hold a certificate of proficiency from a SAPS accredited training provider for a rifle? / Is ’n sertifikaat vir geweer - bevoegdheid aan u toegeken deur ’n SAPS geakrediteerde opleier? Attached copy of certificate / Heg afdruk van sertifikaat aan
Do you hold a certificate of proficiency from a SAPS accredited training provider for a shotgun? / Is ’n sertifikaat vir haelgeweer - bevoegdheid aan u toegeken deur ’n SAPS geakrediteerde opleier? Attached copy of certificate / Heg afdruk van sertifikaat aan:
Do you hold a certificate of proficiency from a SAPS accredited training provider for a handgun? / Is ’n sertifikaat vir handwapen - bevoegdheid aan u toegeken deur ’n SAPS geakrediteerde opleier? Attached copy of certificate / Heg afdruk van sertifikaat aan:
Are you / have ever been a member of a Sport Shooting Association (eg Bisley, Silhoette) Is u / was u ’n lid van ’n Sportskiet Vereniging (bv. Bisley, Silhoette):
For how long have you been a member of your hunting association?/Hoe lank is u ’n lid van u jagtersvereniging?:
Do you reload your own ammunition? Herlaai u, u eie patrone?:
Name two unrelated fellow sport shooters who can vouch for your dedicated participation in sport shooting activities/Noem twee onverwante mede sportskuts wie kan instaan vir u toegewyde deelname aan sportskietaktiwiteite: Name / Naam:
Tel No:
Name / Naam:
Tel No:
Have you attended any Sport Shooting Related Activities during the past two years (Of your Association or Other)? Give Details/By watter Sportskietaktiwiteite was u die afgelope twee jaar betrokke ( van u vereniging of andersins)? Meld besonderhede:
What Sport Shooting activities did you participate in over the past year?/Aan watter Sportskietaktiwiteite het u oor die afgelope jaar deelgeneem?
Activity/Aktiwiteit Member Association/Lidvereniging Telephone No./Telefoon Nr
Available Postal League Scores (At least two) / Beskikbare Posliga Tellings (Ten minste twee):
Give any extra information to support your “Sport Shooting Competence”/Meld enige verdere inligting wat u “Sportskiet Vaardigheid” ondersteun
List your reasons to obtain Dedicated Sport Shooter Status/Verskaf die redes vir die vekryging van Toegewyde Sportskut Status:
Declaration/Verklaring I hereby give permission to CHASA to, in accordance with Regulation 4(2), render information pertaining on my person to the CFR and I declare that I fully understand and abide by the content of CHASA’s Constitution./Ek verleen hiermee toestemming aan CHASA om, ingevolge die vereistes van Regulasie 4(2), inligting omtrent myself aan die SVR te verskaf en ek aanvaar en lê my hiermee neer by die Bepalings van die Grondwet van CHASA.

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