Please enable JavaScript in your browser to complete this form.

Name
Your Full Name - same as the name on your Driver's License. If no Middle Name, use "NMN"
Your House Address or PO Box
Your City of Residence
Your Mailing ZIP Code
Sex
Date of Birth
Your eMail address
If this is a for a Renewal CCW, Your CCW Expiration Date

Gun Info - Provide information for each gun you desire to carry

Maximum 3 guns (Yuba County 5 guns - email fred@TheRangeUS.com with the additional gun info)

Gun #1 Information

Gun #1 Manufacturer
Gun #1 Serial Number
Gun #1 Caliber
Gun #1 Model

Gun #2 Information

Gun #2 Manufacturer
Gun #2 Serial Number
Gun #2 Caliber
Gun #2 Model

Gun #3 Information

Gun #3 Manufacturer
Gun #3 Serial Number
Gun #3 Caliber
Gun #3 Model
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.

Note:

If your email provider has a
SPAM filter, be sure to allow
mail from fred@TheRangeUS.com
CAPTCHA
This question is to prevent automated spam submissions.