Name:  Date of Birth:

Street/PO:  City/Town:

State:Zip:Email:

Telephone (H)(W):(C):               

Course Name:Date:Fee:               

Previous Formal Firearms Training:      

Reason(s) for owning a firearm (Personal Protection, Target Shooting etc...):

Firearm Make to be used on range?:Model?:

Caliber?:  

Have you ever been convicted of a felony?:

Have you ever been convicted of domestic violence?:

Is there a protection order in force against you?:

Where did you hear about us?

Explain your handgun experience and provide your NRA Membership Number if Applicable:

                 

Applicants Signature:Date:               
   $16 RANGE FEE FOR TOP GUN OF MAINE INDOOR RANGE EXERCISES PAYABLE AT RANGE
                                             OUTDOOR RANGES ARE GENERALLY FREE

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You can also pay online and or mail your signed application if you choose.