Course Registration Step 1 of 2 50% Home Firearm Safety Price: Hunter Safety Price: Basic Shotgun Shooting Price: Basic Rifle Shooting Price: Precision Rifle (500 yards) Price: Precision Rifle (200 yards) Price: Basic Pistol Shooting Price: Personal Protection In The Home Price: Personal Defense Level 1 Price: Personal Defense Level Two Price: Concealed Carry Level 3 Price: Concealed Carry Combo - Levels 2 & 3 Price: Defensive Handgun Level One Price: Coupon Code Do you have a Referral Code? Yes No If you have a Referral Code, please enter it here* If you have a Referral Code, please enter it here* Student InformationPlease fill in this info if student is a minor, and use parent / guardian for contact info below.Name* First Last Date of birth* MM slash DD slash YYYY Contact InformationName* First Last Date of birth* MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Address* Phone Number*Emergency Contact Name* First Last Emergency Contact Phone Number*How did you hear about us? (Optional) Eligibility InformationAre you currently under indictment for any criminal charge(s) punishable by imprisonment for more than one year?* Yes No Have you ever been convicted of a felony?* Yes No Have ever been convicted of a misdemeanor offense of domestic violence?* Yes No Are you subject to a restraining order for domestic violence?* Yes No Are you a fugitive from justice?* Yes No Are you an unlawful user of, or addicted to, a controlled substance(s)?* Yes No Have you ever been adjudicated as a mental defective or committed to a mental institution?* Yes No Are you an alien illegally in the United States?* Yes No Have you ever been dishonorably discharged from any branch of the U.S. military?* Yes No Have you ever renounced your U.S. citizenship?* Yes No To the best of your knowledge, do you affirm that you are not prohibited by Federal or State Law from possessing/using firearms and/or ammunition?* Yes No Total $0.00 Please enter your initials if you certify that the above information is accurate*
