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Your Full Name - same as the name on your Driver's License. If no Middle Name, use "NMN"
Your Physical House Address
City of your Physical Address
ZIP Code of your Physical Address
Address or PO Box
Your Mailing Address City
Your Mailing ZIP Code
Date of Birth
Date you were born.
Normal color of your hair.
Select one of the following.
Color of your eyes.
Three numbers - 6 feet 2 inches = 602 and 5 feet 10 inches = 510
Three numbers - 210 pounds = 210 and 98 pounds = 098
Class Date
If you have already called or visited THE RANGE and PAID for your class, enter the Class Date here. Otherwise, leave it blank.


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