North Carolina Bowhunters Association

BCRS Certification Application

                                                  *********PRINT or TYPE... PLEASE !***************

Name: __________________________________________       

Address: ________________________________________        

City/St/Zip: __________________________________________

Phone: (Home) (_____)___________________

Phone: (Work) (_____)__________________    Cell: (______)_____________________________

Email: _____________________________________________

County of Residence:____________________________________

Date of Birth:____________;   Sex:  Male_____ ;  Female: _____

NC Driver Lic. No. ___________________;  "Other" Driver Lic. No. ____________________ State? _______

What is your occupation? __________________________________

Do you belong to a Archery/Bowhunting Club? ______; 

Is this club a NCBA Local Chapter Club? _______;

Name of Club: _____________________________________

How long have you been a NCBA Member? _______________ (Years); Or, New Member? _______(Yes or No)

Are you a NCBA Lifetime Member? _________; If not,  are you interested in becoming a Lifetime Member? _______;

How long have you been bowhunting (Years) ? ________ ; 

Do you consider yourself to be a Full-Time*  bowhunter? _________;   (*ie: Do you hunt (almost) entirely with a bow, even during gun seasons?... more often than not??)

How many BIG GAME animals have you harvested with bow and arrow? (NO CROSSBOWS!)- ____________                    

Have you ever been convicted of any type wildlife violation anywhere? ________;   If YES,  please explain and give details on back of page,  or on separate page attachment.

Attach "copies of certificates" from "Hunter Safety" and "Iternational Bowhunter Education (IBEP) Courses" you have completed.

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Please write a short essay on "why" you want to be considered for certification as a "NCBA BCRS Program Bowhunter" and attach it to this application.

References:  (Two required)

1-Name: _______________________________ 

  Phones: (H)-_____________________ (W)-_____________________ (Cell)-_______________________

2-Name: _______________________________ 

  Phones: (H)-_____________________ (W)-_____________________ (Cell)-_______________________

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If the opportunity arose,  I would like to :  (CHECK ALL THAT APPLY)

_____ Ccoordinate the operation of a "Special Hunts", or become a "County" or "District" coordinator..

_____ Assist at check stations, or checking in animals, as may be required by laws and regulations, or landowner rules.

_____  Assist with checking in certified BCRS hunters or preparing and submitting hunt registration forms.

_____  Serve as a hunting team leader/organizer.

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Bowhunter's Ethics Pledge:

I,  the undersigned,  do hereby pledge and promise that I will:

:    Abide by and obey all state game and trespass laws as well as any additional rules and regulations placed on any special management hunt in which I participate.

:    Cooperate with everyone involved with the hunt and act in accordance with the spirit of the hunt's rules and regulations.

:    Respect the property rights of those who own the land I hunt on as well as those who own adjacent lands.

Signed: _____________________________________________________ Date: _________________________ 

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Bowhunter's WAIVER:

I agree to WAIVE and RELEASE the North Carolina Bowhunters Association and any sponsoring clubs,  agencies or organizations for any and all liability, and "hold harmless" NCBA and any/all clients of BCRS for death or injury, damage or loss of my property.  I agree that NCBA and any/all of it's officer's,  and all clients that I am appointed or contract to perform services for will not be held liable for any such loss or damage to me personally,   or to any of my personal property, by me or any of my family, relatives and/or acquaintances.

Furthermore,  I agree to PAY for any damages done to property of client by me.  I accept this responsibility as a ethical, law abiding bowhunter,   and willingly agree to pay,  repair or replace any property that is damaged by me by accident, intent or negligence,  as directed by the NCBA E.C. and the client. I understand that filing of insurance liability claims will be a "last resort" to rectifying any claims against me by a "client" or "NCBA" as a result of my actions.

Signed: _____________________________________________________ Date: _________________________ 

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General Information Affirmation / Agreement:

I agree to help keep client's property clean of trash.   I will remove all refuse taken onto any property by me.  I will also pick up and remove articles of trash that I observe on the property,  including whole animals I harvest, and that I am able to carry off and properly dispose of on every trip I make onto the property.

I  AFFIRM that the information above is true and factual to the best of my knowledge.  If this application is approved and accepted,  I agree to comply with all rules,  regulations and requirements as set forth by the NCBA-BCRS Program and any "Client" that I may be affiliated with. I understand that any falsification or ommittance of pertinent informaiton in this application is grounds for suspension,  revocation or disqualification of BCRS certification at any time.

Signed:  _______________________________         Date: __________________

Print Name: ____________________________

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NOTARY REQUIRED: (Witness to Applicant's Signatures)

Sworn to and subscribed before me on this date: ________________________

Signed: _______________________________,  Notary Public

My commission expires: ___________________________

Notary Seal:

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Email the BCRS Program Coordinator:  HERE...

BCRS APPLICATION INSTRUCTIONS:

1.    Complete the BCRS Application Form.  Incomplete or illegible applications will be cause for return / rejection of application.  Applications must be signed three (3) times for each section;   Bowhunter's Ethic's Pledge,  Bowhunter's Waiver,  and General Information / Affirmation Agreement.  Signatures on the application must also be notarized by a licensed Notary Public.

2.    Mail Application along with a photocopy of your Bowhunter Education (IBEP or BHE) card and application fee (Check or Money Order for $20.00 ) to:
                        Jeff Morrison, Chmn. NCBA-BCRS
                         104 Goneaway Lane
                         Cleveland, NC  27013
NOTE:  Bowhunters who have sent in a BCRS application form and copies of IBEP / BHE cards in past do NOT need to send another copy of the BCRS application and cards to renew certification.  The application form and copies of Hunter Safety (BHE) and IBEP certification need be sent in only ONE time.. with the initial application.

3.    Additional Information:
        -  The BCRS is program supported by the North Carolina Bowhunters Association (NCBA).  NCBA is a non-profit organization.   The annual fee for BCRS application/membership is used solely to cover the BCRS's operating/administrative expenses and insurance. Paying the fee and being certified does NOT guarantee that you will be selected to participate in a hunt.   Annual fee is $20.00.  Make checks to: NCBA-BCRS

4.    After the BCRS has received and processed your application,  you will receive notification that BCRS has received it.  You will receive a BCRS ID number and letter of acceptance which is valid for ONE year from the date the application was approved.  Your cancelled check or MO stub is your receipt.  The BCPT test must be taken annually.   It may be taken up to 60 days prior to expiration of certification.

5.    BCRS reserves the right to require any approved member to take a "Bowhunter Certification Proficiency Test" (BCPT) at a pre-determined location when deemed necessary; and,   at any subsequent time after initial certification.

6.    There is NO application deadline. 

7.    Priority may be given to BCRS members on a basis of:  BCRS Classification,  County of Residence and longevity in the BCRS program.

8.   The address of our web page is:  www.ncbowhunter.com/BCRS.htm .    This site contains information and news regarding BCRS programs and activities,  such as upcoming hunt plans,  hunt draw information, BCRS application forms,  rules,  regulations, member roster.  Members are encouraged to check the website periodically for new information and developments.   Updates may be included in the quarterly NCBA magazine,  but periodic mailings to the entire BCRS membership via U.S. Mail will NOT be done.  To control and reduce operating costs,  our primary source of disseminating information will be via our website, the NCBA magazine and emailings.

Basic "Accuracy / Proficiency Test"   (APT) Results:  Number of arrows placed (shot) into 6 inch circle at 15 yards (traditional bows); or 20 yards (compound bows) by applicant with his/her hunting bow.  

*Instructions:   Circle numbers (and "X's") individually,  when "Hit."    Record ALL shots, including "X's"   hit.   Shots do NOT have to be consecutive "Hits."  Arrow must "Touch" outside edge of 6" ring (or "X" in center) to count.   

1        2         3        4         5        6         7        8         9        10     (*Req'd:  5 shots in 6 inch circle; 10 shot max.; Shoot all ten shots.)

X       X         X        X        X       X        X       X         X        X      (Record if "X" is hit by circling appropriate "X's" below shot number.)

*NOTE:  BCRS appliants may take the basic APT test more than once,  but ONLY once on any given day. 

Test Conducted by:  (BCRS-APT "Certifier" at time of test)

__________________________________________________ Phone: (_______)_______________________________

RETURN TARGET and RESULTS with APPLICATION.

Click on target to enlarge and "Print";  

IF used for APT test,  "measure" the outside diameter of the circle to assure that they have printed full size.  If circle is larger than the required  6" for the test,  the target is not valid for use in the tests.