TWAW Yuma, Arizona Chapter New Member Profile
Email address *
Last Name *
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First Name *
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Email *
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Phone # *
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Birthday *
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We have a secret Facebook Member Group. Are you on Facebook *
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What is the email associated with your Facebook account so we can send you an invitation to the secret/private group?
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NRA Member
AZ CCW Permit Holder
Have you completed any of the following?
If yes to any of the above please give the dates:
NSSF First Shots ~~~~ CCW Class ~~~~~ NRA Basic Pistol
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Do you currently, or have you ever had, any of the following certifications
If you have other firearms instruction or first aid certifications please list under other.
If yes to any of the above please give the dates:
NRA Basic Pistol ~~~~ NRA RSO ~~~~~ CPR/First Aid
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Firearms Experience Level *
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Do you have any other any other firearms experience and training?
(If USPSA/IPSC, IDPA, SASS, NRA Action Pistol, please include classification)
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I am comfortable shooting (check all that apply)
My dominant hand is my:
My dominant eye is my:
I want more training/education in the following areas:
Emergency Contact Information
The contact information submitted below is effective:
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Emergency Contact Name *
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Emergency Contact Phone 1 *
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Emergency Contact Relationship: *
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Physical/Health
Are there any physical challenges that would be helpful for us to be aware of including vision issues (bifocals, cataracts, etc.), and other major health concerns (epilespy, diabetic). You are sharing this information voluntarily. THIS IS OPTIONAL!
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Are you interested in volunteering with our group?
If you are interested in volunteering, what skills can you contribute?
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Do you grant TWAW, its members/participants at the local, state and national level to post photos of you on our secret Facebook group pages? *
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Do you grant TWAW, its members/participants at the local, state and national level to post photos of you on our PUBLIC Facebook group pages? *
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I agree to abide by all of the rules and policies of The Well Armed Woman. *
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In lieu of a signature, I am typing in my full name below to certify that the above information is true and correct and that I am 18 years of old or older and legally eligible to possess a firearm. *
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