FIREARMS SAFETY COURSE

REGISTRATION FORM
Please fill out form and return to me with check for $125

DATE_______________

NAME____________________________________________________________________
               Last                                         MI                                     First

STREET___________________________________________________________________

TOWN____________________________________________________________________

STATE_____________________________ZIP___________________

DATE/BIRTH_________________________

TEL_________________________________

E-mail_______________________________

NRA MEMBER #______________________
 

ANY PREVIOUS FIREARMS EXPERIENCE________________________

_____________________________________________________________

_____________________________________________________________

SIGNATURE__________________________________________________

    Mail to
Charles Davis
P.O. Box 981
Easton, MA 02334