BACKBONE MOUNTAIN HUNTING CLUB, INC.

Date:____________

“New Member Application”

Please Print Legibly

Name: __________________________________________________________

Address: ________________________________________________________

City, __________________ State:_______________ Zip Code: ___________

Phone No.: (____)________-_________________________

Cell Phone: (____)________-_________________________

E-Mail: _________________________________________

Name of last club you were in, when and where:

__________________________________________________________

President & Phone No.:

__________________________________________________________

1. Have you ever been accused or convicted of any game violations? Yes or No

If yes, explain: __________________________________________________________

2. Why did you leave previous club?

__________________________________________________________

3. How many deer did you harvest last season? Bucks ________ Does ________

4. Do you hunt any other game than deer? Turkey__ Squirrel__ Rabbit__ Other______________________________________________________

5. What type and kind of weapon is your preference during deer season?

Rifle _____ Caliber ______ Shotgun ___ Gauge____

Bow ___ Other ____. If other explain: ______________________________

6. Do you own or have access to any equipment such as tractor, bobcat, dump truck,

etc. that you would use to help improve the club? Yes or No. If yes, list equipment:

__________________________________________________________

7. What skills would you bring to club and why do you think you would benefit the club as a member?

__________________________________________________________

8. What are the qualifications of a trophy buck to you?

__________________________________________________________

__________________________________________________________

9. How do you feel about harvesting does for management purposes?

__________________________________________________________

__________________________________________________________

10. What is your idea of quality deer management?

__________________________________________________________

__________________________________________________________

Which member recommended you: ________________________________________________________

Applicant Must Read and Sign
I certify that I have read and understand all of this application. It is agreed and understood that Backbone Mountain Hunting Club, Inc. or its agents may investigate my background to ascertain any and all information of concern to my background history, whether same is of record or not, and I release Backbone Mountain Hunting Club, Inc. and other persons named herein from all liability for any damages on account of furnishing such information. I further certify that I am a genuine applicant for membership and this application is being submitted solely for the purpose of seeking membership into Backbone Mountain Hunting Club, Inc. and for no other reason. It is also agreed and understood that under the Fair Credit Reporting Act, Public Law 91-508, I have been told that this investigation may include an investigative report including information regarding; my character, general reputation and personal characteristics. I also understand that misrepresentation or omission or facts may result in my rejection or dismissal. If accepted, I agree to abide by all the rules and policies of Backbone Mountain Hunting Club, Inc. This certifies that I completed this application, and that all entries on it and information in it are true and complete to the best of my knowledge.

Applicant Signature: ________________________________________________

Return to BMHC when completed.
565 Lister Drive
Pell City, AL 35125
205-281-6184

President Signature: __________________________________________________

Vice-President Signature: _______________________________________________