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Active Military *

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ATA Membership *

Are you an American Trap Association member?

ATA Membership Number

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Emergency Contact Name *

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Emergency Contact Number *

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IDPA Membership *

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IDPA Membership Number

Law Enforcement Officer *

Are you an active orretired law enforcement officer?

NRA Membership *

Are you currently an NRA member?

NRA Membership Number

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NRA Council Member *

Are you currently and NRA Council Member?

NRA Certified Pistol Instructor *

Are you a certified NRA pistol instructor?

NRA Certified Rifle Instructor *

Are you an NRA certified rifle instructor?

RSO Approved *

Have you been trained as a Range Safety Officer?

RSO Certified *

Have you been certified as a Range Safety Officer?

Shotgun Instructor *

Are you an NRA certified Shotgun instructor?

USPSA Membership *

Are you currently an USPSA member?

USPSA Membership Number

Please provide your current USPSA membership number

Zia Membership *

Are you currently a member at Zia Gun Club

Date of Birth *

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Gender *

How did you hear about us

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