Registration

REGISTRATION FOR ALL CLASSES

Full Name:_______________________________________

Address: _______________________________________

City: ____________________ , NC Zip:_____________

Date of Birth: ____/_____/______

Telephone #: (____) ____-________

PLACE A CHECK MARK BESIDE CLASS REGISTERING FOR

( )   Registration for NC Concealed Carry Handgun Class
( )   Registration for NRA Refuse to Be A Victim Class
( )   Registration for NRA Basic Pistol Class
( )   Registration for NRA First Steps Class
( )   Registration for BOTH NRA Basic Pistol & First
       Steps Class Combined

HOW ARE YOU INTERESTED IN HAVING CLASS

In___terested in having a group class at your location
___Interested in having a group class at one of our locations

___Interested in participating in a class at one of our
locations

Print this form and mail to:

NC Concealed

PO Box 421
Hays. NC 28635

Or fax to: (336) 696-5775

Someone from our office will contact you as soon as possible.