Registration-CPL/CCW-NRA Personal Protection in the Home Class on 10/6

THERE IS A THREE-STEP REGISTRATION AND PAYMENT PROCESS.

First, you will be asked to register your contact information below on this registration form. NO SENSITIVE CREDIT/DEBIT CARD INFORMATION IS ASKED ON THIS PAGE. Second, a new page will appear that will ask you to select how you will pay for your class. Again, no sensitive credit/debit card information is asked. After you’ve made your selection, you will then be DIRECTED TO A SECURED PAYMENT PAGE THROUGH PAYPAL TO PROCESS YOUR PAYMENT.

If you do not want to process your payment online, you will still need to complete the registration form and make an appointment to pay your deposit or full tuition over the phone or in person. Lastly, you can inquire about using CashApp or Venmo   

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Name *

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Last

Age Verification: *

• Confirm that you are 18 years old or older by checking the box.

Address *

Address Line 1

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Phone *

Email *

Due to there is a certification test given at the end of this class, kindly select the following concerns that may be an issue for you so that our staff can better assist you. All information provided is kept private *

• No Issue
• Reading Difficulties
• Hearing Loss
• Vision Impairment
• Hand Injury
• Other.

If selected other please specify.

How did you hear about our Academy? *

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Would you like to join our email mailing list for special updates, class dates, latest news and information? *

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