The Maidstone Gun Club, Inc.

P.O. Box 1588

East Hampton, New York 11937
631-537-7887
E-Mail: maidstonegunclub@USA.net

Dear Applicant:
Thank you for your inquiry about our club. Our range facilities are in East Hampton, New York, two
miles north of Route 27 (Montauk Hwy.), on the East Hampton Airport Road (Daniel's Hole Road).
Shooting is allowed between 9 am and sunset, seven days per week. Our club is a private membership
organization. Our facilities include a 100 and 200 yard rifle range with covered shooting positions,
two skeet and trap fields, an international trap field, a sporting clays and 5-Stand field, a 50 and a 100
ft. outdoor pistol range (both with covered shooting positions), a 50 ft. indoor pistol range, and a
target archery range. The building of our entire facility has been accomplished and paid for in full by
the members of the club. All members are always encouraged to donate time or money to complete
future projects at the club. Your time and support are always greatly appreciated, as are any donations.
No alcoholic beverages are allowed on the property at any time.
You must return all five (5) pages of this completed application to your "1st. Supporting Sponsor" so
s/he can be sure that all questions are completed/answered and mail it to the MGC. If you are a
“family member” applying for membership, you must state who you’re related to and the
relationship to that person. (A Family member is described as, “a member’s spouse or child
(age 18 or under) living in the same house”.)
When your application has been reviewed and tentatively accepted, it will receive a number on our
waiting list. You will be notified when there is an opening in membership and you will be given a
date to attend an orientation class. You MUST attend an orientation class to finalize your membership.
You will be required to pay a $150.00 initiation fee and the annual membership dues at that time. The
dues as of January of 2019 are as follows: 12-15 year olds at $35.00 per member, 16 & 17 year olds
at $50.00 per member, all others at $150.00 per member per year. To be eligible for the youth
discount, proof of age as of December 1st of each year is required. Dues payments are due annually
on December 1st. On the anniversary of your joining, you will also be assessed an additional $350.00
per family, which can be paid in one lump sum or in three annual installments of $100.00, $100.00
and $150.00 respectively. The membership voted for these assessments to cover sudden unexpected
expenses and have been paid by all members, past and present.
Our Club policy is that, any member found to be in violation of the MGC guest policy which limits
a guest to shooting at the club no more than one (1) time in a given month for a maximum of three
(3) times in a calendar year, except when prior special permission was granted by the Board of
Directors for a member to bring a guest three times in rapid succession, may have his/her club
membership suspended for a minimum of six (6) months for the first offense. Further, any applicant
who violates the club’s guest policies may forfeit his/her application for membership in the Maidstone
Gun Club.
Please fill out the attached membership application and have your "1st. Supporting Sponsor" return
the completed application to: The Maidstone Gun Club, Inc., P.O. Box 1588, East Hampton, New
York, 11937. Applications that are not filled out completely will be returned. A nonrefundable fee
of $25.00 must accompany your application to cover administrative costs.
If you have any questions, please contact Stephanie Mamay, the Clerk for Maidstone Gun Club,
between 9 am and 5 pm at 631-537-7887. I look forward to meeting you at the orientation class.
Sincerely,

Walter Johnsen, Jr.

Walter Johnsen, Jr., President Attachments (5)
Rev. 11-22-19 TF
 The Maidstone Gun Club, Inc.
DATE REC'D___________ NO. _____________
MEMBERSHIP APPLICATION
All questions must be answered. Sponsors must sign application and the sponsor sheet.
TYPE OR PRINT ALL INFORMATION LEGIBLY

NAME:_____________________________________DOB:_______________ MGC Family member

(please PRINT) mm/dd/year
MGC Family Member Name and Relationship: _______________________________________________________

MAILING ADDRESS:___________________________CITY:__________________STATE:______ZIP:_________

PHONE:________________________E-MAIL________________________________________________
(please PRINT)
HOME ADDRESS (if different than above)
_____________________________________________________________________________________
OCCUPATION:________________________________________________________________________
BUSINESS ADDRESS: _____________________________ PHONE:____________________________

I certify that I am a citizen of good repute of the United States of America; that I am not a member of any organization
or group having as its purpose or one of its purposes to overthrow by force or violence the government of the United
States or any of its political subdivisions. I have never been arrested or convicted of any felony. I certify that all of the
information provided on my application and questionnaire is accurate and truthful.

SIGNATURE__________________________________________

SPONSORS MUST BE CURRENT MEMBERS IN GOOD STANDING. PLEASE PRINT YOUR NAME LEGIBLY

SPONSOR #1

NAME:__________________________ SIGNATURE:______________________PHONE#:______________

SPONSOR #2

NAME:__________________________ SIGNATURE:______________________PHONE#:______________

SPONSOR #3

NAME:__________________________ SIGNATURE:______________________PHONE#:______________

OFFICE USE ONLY

BOARD APPROVAL:______________________________ORIENTATION DATE:____________________

COMMENTS:_____________________________________________________________________________ pg 1
Rev. 11/22/19 TF
 The Maidstone Gun Club, Inc.

APPLICANT'S QUESTIONNAIRE
YOUR APPLICATION WILL BE VOIDED IF ALL QUESTIONS ARE NOT ANSWERED FULLY AND TRUTHFULLY.

CIRCLE CHECK ANSWER

YES NO
1. HAVE YOU EVER BEEN A MEMBER OF THIS ORGANIZATION?
2. IF YES, WHEN WERE YOU LAST A MEMBER? DATE: _____________________
3. ARE YOU A MEMBER OF THE NATIONAL RIFLE ASSOCIATION?
4. IF NO, WOULD YOU LIKE TO JOIN?
(please circle your choice)
5. I AM INTERESTED IN: SKEET, TRAP, SPORTING CLAYS, RIFLE, ARCHERY, PISTOL.

IF ANY ANSWERS TO QUESTIONS 6 THROUGH 12 ARE YES, ATTACH AN EXPLANATION:

6. HAVE YOU EVER BEEN DISHONORABLY DISCHARGED FROM ANY ARMED FORCES?

7. HAVE YOU EVER HAD A DRUG PROBLEM (I.E. CONTROLLED SUBSTANCES SUCH AS
NARCOTICS OR TRANQUILIZERS, ETC.) OR UNDERGONE ANY TYPE OF TREATMENT
FOR DRUGS OR ALCOHOLISM?

8. HAVE YOU EVER HAD A MENTAL ILLNESS OR BEEN CONFINED TO ANY

HOSPITAL, PUBLIC OR PRIVATE INSTITUTION FOR MENTAL ILLNESS?

9. HAVE YOU EVER HAD A PISTOL/REVOLVER LICENSE, DEALER'S LICENSE,

GUNSMITH LICENSE, OR ANY APPLICATION FOR ANY SUCH LICENSE
DISAPPROVED OR HAD ANY SUCH LICENSE REVOKED OR CANCELED?.

10. DO YOU HAVE ANY PHYSICAL CONDITION WHICH COULD

INTERFERE WITH THE SAFE AND PROPER USE OF A FIREARM?

11. HAVE YOU EVER BEEN ARRESTED, INDICTED, CONVICTED ANY-

WHERE FOR ANY OFFENSE (EXCEPT TRAFFIC INFRACTIONS)?

12. HAVE YOU EVER HAD ANY LICENSE (I.E., DRIVERS OR LIQUOR) ISSUED BY
ANY AGENCY DENIED, REVOKED, CANCELED OR SUSPENDED?

13. HAVE YOU HAD ANY PRIOR EXPERIENCE OR INSTRUCTIONS IN THE USE OF
FIREARMS & HANDGUNS?

14. BRIEFLY EXPLAIN WHY YOU WOULD BE AN ASSET TO THIS ORGANIZATION:

______________________________________________________________________________

______________________________________________________________________________

16. DO YOU HAVE A CURRENT VALID NY STATE PISTOL LICENSE?

LICENSE #:____________________ LICENSE TYPE: ______________________

Rev. 11/22/19 TF pg 2
 The Maidstone Gun Club, Inc.

1ST SUPPORTING SPONSOR QUESTIONNAIRE

DEAR SPONSOR:

IT IS THE RESPONSIBILITY OF THE 1st SUPPORTING SPONSOR TO MAIL THE COMPLETED APPLICATION (FIVE PAGES)
WITH THE NON-REFUNDABLE APPLICATION FEE TO US AT THE MAIDSTONE GUN CLUB, INC., P.O. BOX 1588, EAST
HAMPTON, NEW YORK, 11937. PLEASE BE SURE THAT ALL FORMS ARE COMPLETED BEFORE MAILING. ALL
INFORMATION IS TO BE KEPT CONFIDENTIAL.

PLEASE PRINT ALL ANSWERS LEGIBLY:

SPONSOR'S NAME: ____________________________________________________________________

APPLICANT'S NAME:__________________________________________________________________

1. HOW LONG HAVE YOU KNOWN THE APPLICANT? _______________________________________

2. IN WHAT CAPACITY? _________________________________________________________________

3. HAVE YOU EVER ENGAGED IN SHOOTING SPORTS WITH THE APPLICANT? ________________

4. HOW WOULD YOU PROFILE THE APPLICANTS REPUTATION FOR HONESTY AND SOBRIETY?

_________________________________________________________________________________________

_________________________________________________________________________________________

5. HOW WOULD YOU DESCRIBE THE APPLICANTS ABILITY TO WORK AND GET ALONG WITH
OTHERS? __________________________________________________________________________________

_________________________________________________________________________________________

6. HOW WOULD YOU DESCRIBE THE WILLINGNESS OF THE APPLICANT TO FOLLOW

INSTRUCTIONS AND ADHERE TO NECESSARY CLUB RULES AND REGULATIONS?

_________________________________________________________________________________________

7. WOULD YOU, WITHOUT RESERVATION, ENGAGE IN FIREARM SPORTS WITH THIS

APPLICANT? (DESCRIBE YOUR ANSWER)

_________________________________________________________________________________________

_________________________________________________________________________________________

8. ARE THERE ANY ADDITIONAL COMMENTS YOU CAN MAKE WHICH WOULD ASSIST US IN
EVALUATING THE APPLICANT'S SUITABILITY FOR MEMBERSHIP?.

_________________________________________________________________________________________

_________________________________________________________________________________________

SPONSOR'S SIGNATURE:________________________________________
Rev. 11/22/19 TF pg 3
 The Maidstone Gun Club, Inc.

2ND SUPPORTING SPONSOR QUESTIONNAIRE

DEAR SPONSOR:

IT IS THE RESPONSIBILITY OF THE 2nd. AND 3rd. SUPPORTING SPONSORS TO RETURN THIS QUESTIONNAIRE TO THE
1st. SUPPORTING SPONSOR. ALL INFORMATION IS TO BE KEPT CONFIDENTIAL.

PLEASE PRINT ALL ANSWERS LEGIBLY:

SPONSOR'S NAME: ____________________________________________________________________

APPLICANT'S NAME:__________________________________________________________________

1. HOW LONG HAVE YOU KNOWN THE APPLICANT? _______________________________________

2. IN WHAT CAPACITY? _________________________________________________________________

3. HAVE YOU EVER ENGAGED IN SHOOTING SPORTS WITH THE APPLICANT? ________________

4. HOW WOULD YOU PROFILE THE APPLICANTS REPUTATION FOR HONESTY AND SOBRIETY?

_________________________________________________________________________________________

_________________________________________________________________________________________

5. HOW WOULD YOU DESCRIBE THE APPLICANTS ABILITY TO WORK AND GET ALONG WITH
OTHERS? __________________________________________________________________________________

_________________________________________________________________________________________

6. HOW WOULD YOU DESCRIBE THE WILLINGNESS OF THE APPLICANT TO FOLLOW

INSTRUCTIONS AND ADHERE TO NECESSARY CLUB RULES AND REGULATIONS?

_________________________________________________________________________________________

7. WOULD YOU, WITHOUT RESERVATION, ENGAGE IN FIREARM SPORTS WITH THIS

APPLICANT? (DESCRIBE YOUR ANSWER)

_________________________________________________________________________________________

_________________________________________________________________________________________

8. ARE THERE ANY ADDITIONAL COMMENTS YOU CAN MAKE WHICH WOULD ASSIST US IN
EVALUATING THE APPLICANT'S SUITABILITY FOR MEMBERSHIP?.

_________________________________________________________________________________________

_________________________________________________________________________________________

SPONSOR'S SIGNATURE:________________________________________

Rev. 11/22/19 TF pg 4
 The Maidstone Gun Club, Inc.

3RD SUPPORTING SPONSOR QUESTIONNAIRE

DEAR SPONSOR:

IT IS THE RESPONSIBILITY OF THE 2nd. AND 3rd. SUPPORTING SPONSORS TO RETURN THIS QUESTIONNAIRE TO THE
1st. SUPPORTING SPONSOR. ALL INFORMATION IS TO BE KEPT CONFIDENTIAL.

PLEASE PRINT ALL ANSWERS LEGIBLY:

SPONSOR'S NAME: ____________________________________________________________________

APPLICANT'S NAME:__________________________________________________________________

1. HOW LONG HAVE YOU KNOWN THE APPLICANT? _______________________________________

2. IN WHAT CAPACITY? _________________________________________________________________

3. HAVE YOU EVER ENGAGED IN SHOOTING SPORTS WITH THE APPLICANT? ________________

4. HOW WOULD YOU PROFILE THE APPLICANTS REPUTATION FOR HONESTY AND SOBRIETY?

_________________________________________________________________________________________

_________________________________________________________________________________________

5. HOW WOULD YOU DESCRIBE THE APPLICANTS ABILITY TO WORK AND GET ALONG WITH
OTHERS? __________________________________________________________________________________

_________________________________________________________________________________________

6. HOW WOULD YOU DESCRIBE THE WILLINGNESS OF THE APPLICANT TO FOLLOW

INSTRUCTIONS AND ADHERE TO NECESSARY CLUB RULES AND REGULATIONS?

_________________________________________________________________________________________

7. WOULD YOU, WITHOUT RESERVATION, ENGAGE IN FIREARM SPORTS WITH THIS

APPLICANT? (DESCRIBE YOUR ANSWER)

_________________________________________________________________________________________

_________________________________________________________________________________________

8. ARE THERE ANY ADDITIONAL COMMENTS YOU CAN MAKE WHICH WOULD ASSIST US IN
EVALUATING THE APPLICANT'S SUITABILITY FOR MEMBERSHIP?.

_________________________________________________________________________________________

_________________________________________________________________________________________

SPONSOR'S SIGNATURE:________________________________________

Rev. 11/22/19 TF pg 5