2012 Student Enrollment Form

Complete this form ACCURATELY and submit.

Last Name*

First Name*

Town*

Date of Birth: year/month/day*

Phone: (include area code)*

Email Address:(Enter carefully and CORRECTLY!)*

Please enroll me in the selected course*

Restricted Firearms Safety Course, March 3, Columbus Hall, AylmerOne Stop Firearms Safety and Hunting Course, March 17 and 18, (Both Days) Columbus Club, AylmerFirearms Saftey Course April 14, OSC, Mt. ElginOne Stop Firearms Safety and Hunting Course, April 14 and 21, (Both Days) OSC Mt. Elgin

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