For Basic and Level II firearms courses just answer all questions in the first section.
Security, Fugitive Recovery, Level III and IV please complete section 1 and section 2.

All information is strictly confidential and will only be used for NJFA administrative purposes relating to our courses.

By sending this form you agree to abide by all Laws and safety rules and behavior expressed by NJFA Instructors, the NRA, our Host entities and Common Sense.

Please include any questions in the "Additional Comments" section at the bottom.

Section One

First Name
Last Name
Address1
Address2
City
State
Zip Code
Email address
Home Telephone
Work Telephone
Mobile Telephone
Place of Birth
Date of Birth (MM/DD/YYYY)
U.S. Citizen	Yes No
What is your State of Residence
Have you ever been convicted of a crime?	Yes No
Are you involved in any Domestic Violence issue?	Yes No
Have you ever been convicted of Domestic Violence anywhere?	Yes No
Are you an alcoholic?	Yes No
Do you use any narcotic or controlled substance?	Yes No
Have you ever been confined to a hospital for a mental disorder?	Yes No
Might you have any outstanding warrants or unresolved legal issues?	Yes No
Have you eve been denied a firearms permit or had one revoked	Yes No
Which course(s) are you interested in?
Do you have any health or physical concerns that may effect your ability to do physical activity, or require special accomodation?	Yes No
Fugitive Recovery Agent and Security Training?	Yes No

Additional Comments
Please enter verification code

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Section One

Section Two