Executive Renewal

Your Information
Membership Type:*
- Renewing Member
Membership Card Number:*
Name:*
First Middle Initial Last
Address:*
Street Address Address Line 2 City Province Postal Code
Phone:*
Email:*
Enter Email Confirm Email
Photo Upload
Must be in jpg format and less than 2MB.
Accepted file types: jpg, jpeg, Max. file size: 2 MB.
Emergency Contact Information
Emergency Contact Name:*
First Last
Emergency Contact Phone:*
Additional Information
All firing ranges are mandated by law to collect licensee information. This information is otherwise kept confidential.
Date of Birth*
Month
Day
Year
Do you have a PAL?*
- Yes
- No
PAL Classification:*
Check all that apply.
- Non-Restricted
- Restricted
- Prohibited
PAL Number*
Expiration Date:*
MM slash DD slash YYYY
Membership Policy*
I certify that I am eligible to apply for a Membership.*
Membership
CHOOSE EXECUTIVE
Yearly Membership Fee:*
Name of Spouse:*
First Last
Names of Children under the age of 18:
Use plus icon on the right to add more rows.
First Name Last Name Age
By submitting this form you agree that you need to come in to the office to arrange for your photo ID membership card that serves as your official proof of membership.

Please review your information carefully before hitting submit.

First Name	Last Name	Age

Your Information