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FROM:
TO: LCDR (sel) Jeff Roney, USNMT Interservice and Nationals Rifle Team Captain
SUBJ: APPLICATION FOR MEMBERSHIP IN THE 2011 NAVY RIFLE
TEAM
REF: (a) OPNAVINST 3591.1F (b) OPNAVINST 3590.7C
NAVSEAINST 8370.3A
OPNAVINST 3590.26
ENCL:(1) Completed 2011 Naval Team Questionnaire
(2) 2009 and 2011 Match Participation List
(3) Domestic Violence Disclaimer
1. In accordance with references (a) through (d), I am applying for membership on the 2011 U.S. Navy Rifle Team. Enclosures (1) and (2) detail my experience and availability for the 2011 Rifle Interservice and Nationals matches.
2. Enclosure (3) will be brought to the matches and provided to the Team Captain.
3. Navy Working Uniform (NWU) will be the required uniform for participation in all Inter-service and National events. Summer whites are also required for all related award ceremonies.
4. Alcohol policy during the period of your TAD orders will follow the 12-hr rule. No alcohol consumption 12 hours prior to any scheduled competition. Violation of this rule will result in permanent dismissal from the U.S. Navy Marksmanship Team and UCMJ Art 15 NJP.
(SIGNATURE)___________
2011 NAVY RIFLE COMPETITOR QUESTIONNAIRE
Name: Rank/Rate:Designator: | SSN:XXXXXXLast 4Home Address:Home Telephone: Cell/Travel Telephone: Work Telephone:E-mail Address: Weapon Serial #:Command and Command Address:
Command P.O.C.:
Phone #:Emergency P.O.C
Phone #:
Past Participation:First Year: Most Recent Year:Total Years Participated:USN/USNR Rifle TeamDistinguished Shooter: (circle/bold)YES/NONRA ClassificationFill in current classification: Can be found at HYPERLINK "http://www.nrahq.org/compete/classification.asp" http://www.nrahq.org/compete/classification.asp# of Points:HIGHPOWER RIFLEPresidents 100:LONG RANGE RIFLE Military Rifle Qualification: Other:
Have Previously Fired In:Team Match (Rifle) at InterserviceTeam Match (Rifle) at NationalsNational Trophy Infantry Team (Rattle Battle) at InterserviceNational Trophy Infantry Team (Rattle Battle) at Nationals
Expected/Requested 2010 Participation:Military Berthing Desired (Where Available)VA Regional Rifle Matches (Quantico, Va) (15-17 July) Interservice Rifle Matches (MCB Quantico, VA) (18-28 July). National Rifle Championships (Camp Perry, OH) (30 July -18 August) Check in on 30 July.Small Arms Firing School (30 Jul - 31 Jul) Note SAFS starts on Sat. You must arrive by 0800 on Sat for a muster at the Navy van. Attendance as coach is not mandatory, we want Sailors coaching that WANT to coach. If this is your first year at Nationals and you have no Leg points, you may compete in the Introductory M-16 EIC match, but you must use AMU issued M-16 rifles and ammo . National Trophy Rifle Matches (01-06 August) "CMP WEEK", register at: http://clubs.odcmp.com/cgi-bin/matchInvRegistration.cgi?matchID=5690NRA M1A Springfield Match (Must shoot M1A/M14) (07 August)NRA High Power Rifle Matches (08-14 August) NRA Long Range High Power Rifle and Palma Matches (15-18 August)
Ammunition Requirements:Across the course Rifle (circle/ bold)7.62mm / 5.56mm Long Range ammo (circle/ bold) 5.56mm/7.62mm/ .300 Win MagRifle Requirements: (complete only if you do not have your own rifle)(circle/bold)5.56mm7.62mm | .300 Win Mag
Comments: (travel plans, berthing arrangements, etc.) Enclosure (1)
2090 and 2010 Match Participation List
List matches by category: High Power Rifle, High Power Rifle (Long Range) ---------SCORE---------- DATE MATCH PERSONAL / POSSIBLE
LOCATION
Enclosure (2)
QUALIFICATION TO POSSESS FIREARMS OR AMMUNITIONPRIVACY ACT STATEMENT
AUTHORITY: 18 U.S.C. 922(g)(9).
PRINCIPAL PURPOSE (S): To obtain information for purposes of determining if you have been convicted of a misdemeanor crime of domestic violence which would disqualify you from shipping, transporting, possessing or receiving either Government-issued or private firearms or ammunition and to determine if reassignment, reclassification, or other administrative action is warranted.
ROUTINE USES (S): To the Department of Justice so that such information can be included in the National Instant Criminal Background Check System which may be used by firearms licensees (importers, Manufactures or dealers) to determine whether individuals are disqualified from receiving or possessing a firearm.
DISCLOSURE: Voluntary. However, failure to provide the information may result in the revocation of your authority to transfer, possess, or receive firearms or ammunition and possible adverse administrative action to preclude access to and use of firearms and ammunition. The furnishing of false information also may result in possible criminal or administrative proceedings and sanctions.SECTION1 MEMORANDUM OF ALL SERVICE MEMBERS AUTHORIZED TO POSSESS GOVERNMENT-ISSUED FIREARMS AND AMMUNITION An amendment to the Gun Control Act of 1968 (18 U.S.C. 922) makes it a felony for anyone who has been convicted of a misdemeanor crime of domestic violence to ship, transport, possess, or receive firearms or ammunition. It is also a felony for any person to sell or otherwise dispose of a firearms to any person so convicted. The law pertains to anyone who has ever been convicted of a domestic violence misdemeanor. There is no exemption for military personnel or law enforcement officer and agents.
Convictions of misdemeanor crimes of domestic violence as defined in the amendment do not include summary court-martial convictions, the imposition of non-judicial punishment (Article 15. UCMJ), or deferred prosecutions (or similar alternative dispositions) in civilian courts. The law also excludes anyone whose conviction has been expunged or set aside, or who has received a pardon. A misdemeanor crime of domestic violence in any offense which has, as its factual basis, the use of attempted use of physical force, or the threatened use of a deadly weapon, committed by the victims current or former domestic partner, parent, or guardian. If you have ever been convicted of a misdemeanor crime of domestic violence within the meaning of the law, continued retention of any firearm or ammunition, whether Government-issued or privately owned, may subject you to felony criminal penalties including a sentence of imprisonment of up to ten years and a fine of up to $250,000. as well as administrative action.
If you have ever received a qualifying domestic violence misdemeanor conviction: (1) you may not possess any firearm or ammunition: and (2) you must return any Government-issued firearm or ammunition to your commander or immediate supervisor. Furthermore, any previously issued authorization to possess a firearm or ammunition is revoked.
Complete the qualification inquiry below and return to your commander or immediate supervisor within ten (10) working days of receipt. If you have any questions, you may contact your immediate supervisor, a legal assistance attorney, or a private attorney.SECTION II ELEMENTS OF MISDEMEANOR CONVICTION OF DOMESTIC VIOLENCE A person shall not be considered as having committed a misdemeanor crime of domestic violence or purposes of the firearms restriction recently added to the Gun Control Act unless all of the following elements are present:the person was convicted of a misdemeanor crime;
the offense had as an element the use or attempted use of physical force, or threatened use of a deadly weapon;
the convicted offender was at the time of the offense:
a current or former spouse, parent or guardian of the victim.
A person with whom the victim shared a child in common,
A person who was cohabiting with or has cohabited with the victim as a spouse, parent, or guardian or
A person who was similarly situated to a spouse, parent or guardian of the victim;the convicted offender was represented by counsel, or knowingly and intelligently waived the right to counsel:
if entitled to have the case tried by jury, the case was actually tried by jury or the person knowingly and intelligently waived the right to have the case tried by jury;
the conviction has not been expunged or set aside, or the convicted offender has not been pardoned for the offense or had civil rights restored., unless he pardon, expungement, or restoration of civil rights provides that this person may not ship, transport, possess or receive firearms.Section III - QUALIFICATION INQUIRY (Complete and return to your commander or immediate supervisor within 10 days of receipt)1. HAVE YOU EVER BEEN CONVICTED OF A MISDEMEANOR CRIME OF DOMESTIC VIOLENCE AS DESCRIBED ABOVE: (Initial and Date)YESNOI DON'T KNOW (Provide explanation on separate sheet)2. IF YOU ANSWERED "YES" TO THE FIRST QUESTION, PROVIDE THE FOLLOWING INFORMATION WITH RESPECT TO THE CONVICTIONa. COURT/JURISDICTIONb. DOCKET/CASE NUMBERc. STATUTE/CHARGEd. DATE SENTENCED (YYYYMMDD)3. CERTIFICATION. I hereby certify that, to the best of my information and belief, all of the information provided by me is true, correct, complete, and made in good faith. I understand that false or fraudulent information provided herein may be ground for adverse action, up to and including removal, and is also criminally punishable under the Uniform Code of Military Justice or under federal law.a. NAME (Last, First, Middle Initial)
b. TITLE
c. AGENCY/DUTY STATION
d. SIGNATUREDATE SIGNED
(YYYYMMDD)
USN/USNR Rifle Team Application
Complete application, save as "LastName_Rank" and email to LCDR (sel) Jeff Roney at jeffery.roney@navy.mil
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