Course Enrollment Form Homegunsafety.com

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Please enter your Name as you would have it printed on your certificate. *

Please enter your email address we can use to contact you. *

Please enter the best phone number we can use to contact you. *

Please enter your street. *

Please enter your city, state, and zip code *

Please enter the best time(s) to call you. *

Are you left handed or right handed? *

Please tell us about your firearms experience. *

Requested Course Date *

Please let us know if have additional information which we should know about.

Please let us know the course you are enrolling in. *

Thank You!

Thanks so much for your interest in a Firearms Course with us. We will contact you as soon as possible.

You can submit payment either on line using a credit card (MasterCard, Visa, American Express, Discover, or Electronic Draft) on your course page at http://www.homegunsafety.com with a secure encrypted site at the bottom of the page (look for the credit card images) or you can send a check or money order PO Box 73, Hopkinton, MA 01748-0073 made payable to Mike Burchman. Many people do decide to pay with a credit card on line, so they usually fulfill requirements quickest. We confirm seats in the class and send directions to the course when we receive both the course enrollment form and payment due to limited seating and not allowing walk-ins for the course.

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