Course Dealer Submission Only
This form is used for our dealers. If you are not a dealer, but would like to register for a class or have questions, please click on the 'Contact Us' tab above, then fill in and submit the form on that page. Thank you.
Student's Name
Fill in the full name of the student taking the course
Name of Course
CCW, Tactical Pistol Lvl 1, PDEF, etc.
Date of Course
Find scheduled courses by reviewing the calendar tab of this website.
Student's Phone Number
Student's Email Address
Student DOB
Student Address
Student Emergency Point of Contact
Someone other than the student. Name and phone number.
Student's Relevant Experience
Former military, competitive shooter, beginner, hunter, etc.
Sales Person
Receiving credit for this sale
Today's Date
Date of registration
Store Name and Location
Has Student Been Briefed
Where to go, when to go, what gear to bring, how much ammo, etc?
Did Student Pay in Full
Dealer should be collecting full payment.
Amount Paid
Balance Owed
Do you, as the sales person, see any specific concerns or issues we will have to address with this client?
Please provide any helpful information. Thank you.
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