Please complete all fields

Class Date: Month *
Class Date: Day *
Name: *
Address: *
Phone: *
E-mail: *
How did you hear about
List any Medical Conditions we need to be made aware of for classroom and range training
Will you be renting a handgun for range qualification test?
PISTOL Type. We STRONGLY SUGGEST qualifying with Semi-Auto. If you only have revolver, please rent a Semi-Auto for Qualification on Range
If using your own pistol, what caliber handgun will you use on range qualification?
Make & Model (example: Glock 19)
Pistol Experience
Describe any Firearms Training & Experience
Are you in the market for firearms &/or gear? What’s your WISH LIST?
Approx. # PISTOL rounds shot in past 12 months?
How many hours do you practice each month?
Interested in Training in following areas:
Interested in Purchasing in future:
I am a Person! Solve Equation