I do hereby affirm that the information I have entered above is true and correct. I understand that when I click the "SUBMIT" button below for this form that it is the same as if I had signed my name in person and carries the full legal weight
of a personal signature.
I understand that while terminology may differ colloquially and in the written form, "Concealed Handgun Permit (CHP), "Concealed Handgun Carry" permit (CHC)," and "Carry Concealed Weapon (CCW)" permit are all variations of a generic authorization to carry a concealed handgun legally while in possession of the New Mexico permit.
By submitting this Student Information Sheet, I certify that I have read and understood the information contained within NMAC 29-19-4, titled "Applicant Qualifications," including sub-sections A. and B. As such, as of the signing of this document, I also certify that I am eligible for a New Mexico Concealed Handgun permit. I understand that if I am denied a permit by the State of New Mexico for whatever reason, I shall not hold Michael R. Grimler, the Los Alamos Sportsmen's Club, the County of Los Alamos, or the US Department of Energy responsible for such denial.
I understand that these NM CCW classes are designed for shooters of at least an INTERMEDIATE
skill level. As such, I affirm that I am familiar with withdrawing my firearm safely from a strong-side hip or strong-side "Inside the Waistband" (IWB) holster, safely re-holstering, the fundamentals of marksmanship to include sight picture, sight alignment, stance, grip, trigger pull, and I am familiar with the proper and safe loading, safe unloading and safe and efficient reloading of any firearm in my possession, to include the firearm(s) with which I will shoot the qualification course of fire.
I further understand that I may be asked to leave the class, if directed by the instructor, for any firearm safety violations observed or reported. If I am asked to leave the class for such safety violations, I may forfeit all or part of my paid class fee. I acknowledge that Michael R. Grimler, Firearm Instructor reserves the right to refuse instruction to anyone before the class starts. If I am refused instruction before the class starts
, I am entitled to a full refund of any class fee paid to date.
I also certify that I have reviewed the NM DPS "qualifiers" and "disqualifiers" in the official NM DPS CHC permit application and law and have self-determined that I am qualified to possess an NM CHC permit following training and NM DPS processing.
I understand that class fees are non-refundable. If I have pre-paid for a class and am not able to attend, my fee will be applied to the next available class that is offered. If I decide to not use the pre-paid class fee for an NM CCW class, I may apply it towards private firearm lessons at the rate of $45/hour. I understand that private firearm lessons will be given at a mutually-agreeable date and time at the Los Alamos Sportsmen's Club facility.