South African Professional Firearm Trainers Council

1. South African Professional Firearm Trainers Council Special General Meeting (SGM) Friday 14th March 2014

2. Professional Range Officer Professional Firearms Instructor Professional Tactical Firearms Instructor Professional Firearm Training Specialist Professional Firearm Training Counselor PROFESSIONAL Designations

4. APPLICATION FOR A PROFESSIONAL PFTC DESIGNATION Name of Applicant: __________________________________ Date: _________________ Designation being applied for: (Please tick the appropriate block). You may only hold one designation at a time. You may not apply for a new designation within six months of being awarded any other designation. An administration fee of R200 is required per application. Please attach a copy of your CV as well as all relevant supporting evidence.

5. Please attach a copy of your CV as well as all relevant supporting evidence. • What is your age? ___________________________________________________ • How many years of firearm experience do you have? ________________________ • Describe your primary job function and the company name where this takes place: ______________________________________________________________________________________________________________________________________ • For how many years have you been involved in training other people with firearms? ___________________________________________________________________ • How many times a year do you shoot a firearm? ____________________________ • Approximately how much ammunition do you shoot per year? Handgun ___________________________________________________________ Shotgun ____________________________________________________________ Rifle _______________________________________________________________

6. List all the firearms licenced in your own name? (Serial numbers are not necessary) __________________________________________________________________ • ______________________________________________________________________________________________________________________________________ • List any firearms under your control for business purposes ____________________ • ______________________________________________________________________________________________________________________________________ • Are you involved in a community service of any kind? If yes, please explain: ______ • ___________________________________________________________________ • ___________________________________________________________________ • ___________________________________________________________________ • List all the companies/ places where you have been employed in the last ten years • ___________________________________________________________________ • ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ • Give the names of three people who would be prepared to give a character reference on your behalf: • Name: ___________________________________Contact nr: ________________ • Relationship ________________________________________________________ • Name: ___________________________________Contact nr: ________________ • Relationship ________________________________________________________

7. Name: ___________________________________Contact nr: ________________ • Relationship ________________________________________________________ • Are you a member of any Clubs/ Shooting Associations? ___________________________________________________________________ • How long have you been a member of the PFTC? ___________________________ • Have you ever been awarded “dedicated status”? If yes, please give details: ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ • For the Awards Committee, please supply the following information: • Full Names: _________________________________________________________ • ID number: _________________________________________________________ • E-mail address: ______________________________________________________ • Cell phone number: __________________________________________________ • Landline number: ____________________________________________________ • Fax number: ________________________________________________________ • Employer name: _____________________________________________________ • Town & province where you normally reside: _______________________________ • If you have any questions for the Awards Committee please list below: __________ • _________________________________________________________________________________________________________________________________________________________________________________________________________

8. Is there any other information that the Awards Committee should know about you? ___________________________________________________________________ • ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ • Have you signed the PFTC Code of Conduct? If yes, please attach a signed copy to this application ______________________________________________________ • Signature: __________________________________________________________

11. QUESTIONS ON DESIGNATIONS?