CONCEALED WEAPON CARRY CLASS
Saturday, March 14, 2015
8:00 A.M. – 5:00 P.M.
Classroom Location: Ward 6 Fire Department, Station #2, 108 Marcantel Road, DeQuincy, LA
(The afternoon shooting portion of the class afternoon will be held at the DeQuincy Shooting Range)
INSTRUCTOR: TOM THREET
$100.00 per student (cash, check, money order made out to: Colors for a Cause)
Colors for a Cause will receive 50% of each registration fee.
REGISTRATION FORM
(Please PRINT Clearly)
DRIVERS LICENSE #
SEX (circle one)
NAME
MALE
FEMALE
DATE OF BIRTH
First
Middle Initial
Last
STREET ADDRESS
CITY
STATE_
HOME PHONE
OTHER PHONE
ZIP
EMAIL ADDRESS
Class fee is $100.00 and is not refundable.
Do you want the optional NRA Certificate, book, pin?
(this is $15.00 extra, circle yes or no):
Yes
No
TOTAL AMOUNT ENCLOSED: $ ___________
Please note: This instructional class is required in order to apply
for concealed carry permit from the Louisiana State Police.
Each student will be responsible for completing and filing the necessary
application and paying the Louisiana State Police concealed carry permit fee.
Visit www.lsp.org/handguns.html for information on permit process and filing fees.
See Next Page
INSTRUCTIONS FOR ATTENDING CLASS
Plan to arrive 15 minutes prior to the start of class. It is imperative that you do not
miss any of the material covered in this class as it is required by law to obtain your
permit. Class starts at 8:00am and ends at 5:00pm. Free lunch will be provided.
Shooting will be done outside on afternoon of class, so if it is cold, rainy, etc. please
dress appropriately. You will need to bring the firearm with which you wish to qualify.
It must be unloaded and no ammo may be brought into the class until so advised. You
will need to bring eye and ear protection. You will need to bring 50 rounds of
ammunition for your firearm. Bring your identification, Driver’s License or State ID to
class with you. You will not be admitted to class without it.
Mail your registration form and instruction sheet with your payment so that
we receive it no later than March 6, 2015. Payment must be received prior
to the scheduled class date in order to reserve your seat. Make check/money
order payable to: COLORS FOR A CAUSE. Mail your registration form and
check/money order to: COLORS FOR A CAUSE, P.O. BOX 1211, DEQUINCY, LA 70633.
Cancellation policy: If you cannot attend, you must give 2 week notice in order to
allow us time to fill the seat. Exceptions can be made for legitimate emergencies such
as a death in the family.
Cancellations made one week or less before the start of the class will be charged a $50
cancellation fee if the seat cannot be filled. If you do not show up, your class fee is
automatically forfeited.
I, the undersigned, have read and fully understand the class instruction sheet. I agree
to all safety procedures. I understand this is a concealed carry permit qualification
class and not a course to teach the operations of firearms. I understand that class fees
are non-refundable. I understand there is a $50.00 service charge on any nonsufficient funds check. I certify that the statements I have made above are true and
correct and I agree to all terms and conditions of this class as stated on the
registration form and on the class instruction sheet.
Signature
Print Name
Date