Name: First, Middle, Last

Class Registration Information Form

Mailing Address: Include City, State and Zip Code

Date of Birth: MM/DD/YYYY

Working Phone Number:

E-mail Address: (optional)

Select Training Program:

Are you at least 21 yrs of age?

Have you ever been CONVICTED of a Domestic Violence Crime or any Felony?

Have you ever been DISHONORABLY discharged from the Armed Forces?

Are you mentally unstable or been committed to a mental hospital?

Disclaimer

CCW Permit Training:

I do agree to make payment in full on or before the day of the actual training, if FULL payment is not made on or before the day of the training I do acknowledge that I will be dropped from the training and will not be allowed to attend.  If I am unable to attend the current training I have registered for I will notify STS so that I may be moved to the next available training date. I do also attest and affirm that the above info is true and correct.

Armed and Unarmed Security Training

I (We) do agree to have all the required items needed for the class and do acknowledge that STS is NOT required to provide any ammo, batons, handcuffs, cases or firearms for any of the training(s).  I (We) do also acknowledge that payment for any training provided by STS will be paid in full on or before the training date unless other arrangements have been made. I do also attest and affirm that the above info is true and correct.

Mailing Address:

(Select Training Program)Arizona CCW (October 1, 2011)NRA Basic Pistol TrainingNRA Protection in the HomeAZ Armed Security TrainingAZ Unarmed Security Training

YesNo, but at least 18

YesNo

YesNoDoes not apply

YesNo

I agree

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