Application Form Please leave this field empty. Your Name Your Email Address City State Zip Code Phone Number Date Of Birth Place Of Birth Are You A US Citizen? YesNoIf 'No' what is your residency status? Gender (If you are or may be pregnant, we strongly recommend you refrain from shooting.) MaleFemale Have you ever been convicted of a crime? YesNo Might you have any outstanding warrants? YesNo Have you ever been convicted of any domestic violence in any jurisdiction? YesNo Have you ever had a firearms license or permit refused or revoked? YesNo Have you ever been hospitalized for a mental reason? YesNo Do feel like you want to harm yourself ? YesNo Do you suffer from depression? YesNo Do you use a narcotic or other controlled substance? YesNo Do you have any condition that may make it hard to use a firearm? YesNo Is your home a safe place to keep a fire arm? YesNo Do you believe in your second amendment rights to own firearms?.. YesNo What courses are you interested in? Referred by? Do you have any health or physical concerns that may effect your ability to do physical activity, or require special accommodation? YesNo Additional Comments If you are applying for Advanced or Security training, please complete the below questions. If you are NOT, skip to the bottom to complete the Anti-Spam verification and press 'submit'. Will you consent to a background investigation? YesNo Will you have medical clearance to participate in related physical activities? YesNoHeight (Ft. - In.) Weight (Lbs) Eye Color Hair Color Do you currently have medical coverage? YesNo Highest level of education? HS / GED, 2 year degree (Associate)4 year degree (Bachelor)Graduate Degree (Masters)Post-Grad (Ph.D, J.D., M.D., etc.) What (valid) certifications do you currently hold? CPRNRAEMTOtherNone What (valid) certifications do you currently hold? (others) Are you currently working in security, or a related field? Your blood type (if known) Please list any allergies, including dog, if any: Do you hold a valid driver's license? YesNo Any medical condition of concern?
