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Online Registration    

1. Course you wish to attend:	August 15, New CHL, 9 am to 7 pm August 15 Renewal, 9 am to 12:30
2. Choose type of course:	CHL (10 hours) Cost $125 Rnewal Course $85
3. First Name
4. Last Name
5. Middle Initial
6. Age
7. Email Address
8. Drivers License #
9. Address
10. City
11. State
12. Zip
13. Phone
14. Emergency Contact Name:
15. Emergency Contact Phone Number:
Firearms Information:
16. Do you own your own handgun?	Yes No
17. If yes, what make/model/caliber?
18. If no, do you need a handgun provided to you to qualify?	No Yes
Do you have any physical limitations, injuries, mental defects, or limitations whether physical or mental which would prohibit you from successfully completing this course or from safely firing a handgun?
19. No
20. Yes
21. If yes explain
22. How did you hear about us?	Friend Google Yahoo Other Online Search Vehicle Ad Business Card Gun Show Classifieds
23. Additional Comments?