Concealed Carry Registration Form

Bring the following to Class: Valid Kansas I.D. (Driver’s License.)

COST = $80.00 Receipt of this form and $20.00 will be your registration for the class. The balance ($60.00) will need to be paid on the day of the training.

Pen or Pencil

Failure to show up for training without prior arrangements will result in a loss of your deposit ($20.00.)

Eye & Ear protection

A handgun.

75 rounds of ammunition for your gun LOCATION: Mentor Fire House 697 E. Mentor Road, Mentor KS Just south of Salina on Old 81 Hwy. The shooting portion will take place in the country east of Assaria and we will drive there as a group. LUNCH PROVIDED We will have coffee, tea and water throughout the day. We will provide donuts in the morning. At lunch time we will provide you with a full lunch so you do not have to leave. If you have dietary restrictions you can bring your own lunch. There will be a refrigerator and a microwave at the firehouse.

Qualification is 25 rounds. You will be given 2 chances to pass, remedial instruction, and 1 more chance to pass. (Don’t worry, this happens VERY rarely but I need to mention it)

[email protected] Facebook: sandsccw For more information or to check out upcoming events, use the email above or visit our facebook.

CLASS WILL START AT 8AM & WILL END AROUND 5PM If you need to attend as a group send them all in one envelope DO NOT bring firearms or ammunition into the classroom. UNLOAD your handgun and all magazines and leave them in your vehicle.

Cut on the line and send the below section of the form to: ------------------------------------------------------------Cut Here--------------------------------------------------------------------------Shannon Clarkson 118 Raleigh, Salina KS 67401

Name: E-mail: Phone #: Course Date:

DOB: Address: Handgun

Send $20.00 with this form