PHILIPPINE PRACTICAL SHOOTING ASSOCIATION

3rd Floor Macrima Bldg. cor. EDSA Escuela St. Nuevo Makati City
Telephone No. 8828244 Fax 8827973
Email: a.ppsa@yahoo.com.ph / rjbautista.ppsa@yahoo.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

Occupation

Membership Type

Regular

Honorary

RCS Classification

Master

NROI Ranking

Grand
Master
Range
Officer

Mother Club Name

Single

Married

Gender
Blood Type:

Life Membership Date:

A

Chief Range
Officer

DD

Range
Master

RO POINTS

Position:

Contact Information Home

Address

Email Address:
Contact Information Office
Address

Zip Code

Mobile No.

Telephone No. :

Email Address:

Zip Code

Mobile No.

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:
A. Fill up Individual Membership Application
Form
B. Attach 2x2 colored picture 1 pc
C. Gun club President Signature
D. Membership Fee

MEMBERSHIP FEES:
New Member
Regular Member
P 2,000.00
Regular Junior
1,000.00
Lawman (PNP, AFP) 500.00
Lifetime
10,000.00
Switch to Life
N/A
NALECC
1,000

RANGE OFFICERS:
Renewal
P1,000.00
500.00
500.00
NONE
9,000.00
500.00

-Lawman and NALECC must present their

current active ID to avail the discounts.
-Rates are subject to change without prior
notice:

A.

B.
C.

Active Range Officers who have served

a minimum of 18 points are exempted
from these fees as long as they are
endorsed by the NROI Secretariat
All Range Officers must be endorsed
by their Gun Club President
Policies may be changed by the PPSA
Board of Directors.