F3- Final Individual Entry Form

13th M.L.A.I.C. European Championships NÁQUERA (VALENCIA) - SPAIN - 2009 Club Valencia de Tiro Olímpico y Club de Chest FORM- F3: INDIVIDUAL FINAL ENTRY FORM - DEADLINE 1st JULY, 2009 Personal details Title (Miss, Mrs or Mr)

Delegate

Surname(s)

Chief of Delegation

First Name

Team Captain

Date of Birth

Competitor

Nationality

Perman. home address: Telephone:

e-mail:

Address when in Spain: Telephone:

e-mail:

Details of firearms used at Championships in Spain for MLAIC events Nr. MLAIC EVENTS 2 MAXIMILIAN 3 MINIE 4 WHITWORTH 8 WALKYRIE 1 MIQUELET 14 TANEGASHIMA 16 HIZADAI 15 VETTERLI

O/R

Type of Firearm

Make's name

Cal.

Serial number

36 PENNSYLVANIA 37 LAMARMORA 6 KUCHENREUTER 7 COLT 12 MARIETTE 23 DONALD MALSON 38 REMINGTON 5 COMINAZZO 28 TANZUTSU 21 MANTON 22 LORENZONI

O R

Name of Association / Federation:

Date:

Team Captain's signature:

Please return this FINAL FORM by e-mail, fax or mail before 1st July, 2009 to: Real Federación Española de Tiro Olímpico C/ Sombrerería 22, MADRID 28012 - SPAIN Fax Nr (34) 91 527 37 21 - E-mail: [email protected]