Registration Form

Registration Form
( Print & Complete )

Name: ____________________________________________________________________________________________________

Last

First

Middle

Street Address:
__________________________________________________________________________________________________

City

State

Zip

___________________________________________________________________________________________________________

Home Phone #

Business Phone #

Cell Phone #

Fax #

___________________________________________________________________________________________________________

Age

Email Address

_______	AZ CCW PERMIT CLASS	$099
_______	UT CCW PERMIT CLASS	$099
_______	FL CCW PERMIT CLASS	$179
_______	MULTI-PERMIT CCW PERMIT SPECIAL	$159
_______	BASIC HANDGUN SAFETY & MARKSMANSHIP	$259

Date of Class you wish to attend:	___________________________________	(See Schedules)
	Available on 1st come 1st serve basis

Method of Payment:
_______	Personal Check	_______	Money Order	_______	Cashiers Check (Mail Check with form)

I understand that the cost of the course checked above is non-refundable and that any change in schedule
must be made at least 72 hours prior to date of course and approved by Arizona Defensive Firearms Training,
a division of RB Investigations, LLC. There will be a $25 Charge for returned checks.

Signature _________________________________________________ Date _____________________________

Mail this form along with Check Cashier's Check or Money order.
Mail to: RB Investigations, LLC • PO Box 44302 • Phoenix, AZ 85064
Note: You will receive a CONFIRMATION by e-mail or by letter, along with a map to range 5 days prior to class.