|
ASAA/LFI TRAINING
APPLICATION
(Please Print and Mail to Address Below)
Course _____________________________________
Date _____________
Course _____________________________________
Date _____________
Name
_________________________________________________________
Address
_________________________________________________________
City
______________________________ State ____ ZIP___________
Home Phone
( )____-______ Email Address ____________________
Brief resume of shooting background
_________________________________________________________________
_________________________________________________________________
Weapon(s) to be used for training
__________________________________________________________________
_________________________________________________________________
Documents enclosed (A copy of any one)
[ ] Concealed Carry Permit [ ]
Law Enforcement Officer ID
[ ] Letter from
Police/Judge/DA [ ] Letter from Attorney
Payment of $____________ enclosed
via
[ ] Check [ ] Mastercard
[ ] VISA
Card # ____________________ Exp._______ ### Back of Card
_______
If your credit card is billed to an address
different than the one above please enter it below this line.
I am aware I can be expelled from any course, without
refund, for conduct which the instructor or staff feels endangers or disrupts the
class. Deposits are not refundable if cancellation is less than 30 days prior to
class, but may be applied toward future courses.
Signature
Mail to Defense Associates, P.O.
Box 824, Fairfield, CT 06824
|